Formation of a true knot in subclavian venous catheter in a patient in the intensive care unit (original) (raw)
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A Formation of a true knot in subclavian venous catheter in a patient in the intensive care unit
2020
Vascular catheters installation is most frequently used in critical care units. A node in the catheter lumen is a rare mechanical complication of the central venous catheterization. The 14-year-old was treated for acute appendicitis complicated by diffuse purulent peritonitis. It was decided to install a central venous catheter on the very first day of treatment. A catheterization of the right subclavian vein according to Seldinger was carried out. The catheter functioned properly for 6 days. On the 7th day, in the process of removal of the catheter, its extraction was blocked at a 1 cm depth from the tip. The catheter was removed by strong physical force with the occurrence of a hematoma in the area of installation of the catheter. Once removed, on the catheter there was found a node, formed inside the vessel. In this case, no disabling and life-threatening complications as a result of the use of the catheter were recorded. In the future, the patient was discharged recovered.
A Knot of the Central Catheter Created During Usage Period
Journal of Medical Cases, 2011
The use of central veins catheters for diagnostic and therapeutic purposes is a common procedure in intensive care unit (ICU) and operating rooms. This procedure, even if performed by skillful hands, might cause complications during the insertion maneuvre or in the course of use. Preventing and decreasing the rate of the complications requires a correct technique application, from the insertion to the withdrawal procedure of the catheter. We are describing a rare complication case, which occurred a few days after the insertion of the catheter. The mechanisms of the presented complication must be rare, but is potentially possible.
Jugular Venous Catheterization: A Case of Knotting
Case Reports in Medicine, 2015
A 79-year-old woman, diagnosed for cancer of the ovary, had a central catheter that was placed with difficulty through the right internal jugular vein intraoperatively. After oophorectomy, it was realized that the catheter was knotted. Thus, the central venous catheter was removed successfully using a traction technique in the operating room. Central venous catheter use may result in various complications, although it has been used as an invasive method for hemodynamic monitoring and fluid and drug infusion. Here, we present catheter knotting in a case with solutions for this complication, under literature review.
2004
A particular event concerning a Swan-Ganz catheter complication is reported. A 41-year-old woman was admitted at the emergency room of our hospital with massive gastrointestinal bleeding. A total gastrectomy was performed. During the postoperative period in the intensive care unit , the patient maintained hemodynamic instability. Invasive hemodynamic monitoring with a pulmonary artery catheter was then indicated. During the maneuvers to insert the catheter, a true knot formation was identified at the level of the superior vena cava. Several maneuvers by radiological endovascular invasive techniques allowed removal of the catheter. The authors describe the details of this procedure and provide comments regarding the various techniques that were employed in overcoming this event. A comprehensive review of evidence regarding the benefits and risks of pulmonary artery catheterization was performed. The consensus statement regarding the indications, utilization, and management of the pul...
The Stuck Central Venous Catheter: A Word of Caution
Heart, Lung and Circulation, 2008
432 Case Reports Heart, Lung and Circulation 2008;17:417-436 31. Kurian KC, Edwards FH, Jacob B, Monteiro C, Chiong J. Papillary fibroelastoma presenting as left ventricular mass. Tex Heart Inst J 2006;33:63-5. 32. Ulusoy RE, Kilicaslan F, Kirilmaz A, Kardesoglu E, Cebeci BS, Dincturk M, Yilmaz AT. Papillary fibroelastoma of mitral papillary chordae in a young patient. Int J Cardiovasc Imaging 2006;22:601-3. 33. Borsani P, Mariscalco G, Blanzola C, Leva C, Bruno VD, Cozzi G, Casnedi S, Dainese E, Sala A. Asymptomatic cardiac papillary fibroelastoma: diagnostic assessment and therapy. J Card Surg 2006;21:77-80. 34. Turi GK, Albala A, Fenoglio Jr JJ. Cardiac fibromatosis: an ultrastructural study. Hum Pathol 1980;11(5 Suppl):577-80. 35. Fekete PS, Nassar VH, Talley JD, Boedecker EA. Cardiac papilloma. A case report with evidence of thrombotic origin. Arch Pathol Lab Med 1983;107:246-8. 36. Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB. Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation. J Am Coll Cardiol 1997;30:784-90. 37. Topol EJ, Biern RO, Reitz BA. Cardiac papillary fibroelastoma and stroke. Echocardiographic diagnosis and guide to excision. Am J Med 1986;80:129-32.
A patient with an uncommon complication from insertion of a central venous catheter: A case report
Cases Journal, 2008
Background: A 72 year old male was admitted to the medical intensive care unit with septic shock. Case presentation: A left subclavian central venous catheter was inserted on the day of admission whose tip was pushing against the wall of the vessel lumen. The patient's condition improved with treatment, but three days later had a new episode of acute hypotension. CT scan of the chest showed that the catheter had eroded through the superior vena cava wall. Conclusion: The catheter was pulled out and patient recovered from the complication with supportive therapy. Care should be taken that the tip of the catheter is in the center of the vessel lumen to avoid this rare, but potentially life threatening, complication.
Removal of Knotted Intravascular Devices. Case Report and Review of the Literature
European Journal of Vascular and Endovascular Surgery, 2002
Objective: to review published reports on knotted intravascular devices/catheters. Method: report of two cases and systematic review of the literature. Results: a total of 113 reported cases of knotted intravascular devices/catheters were located. Pulmonary artery catheters (Swan-Ganz) were responsible for more than two thirds of the total reported intravascular knots. In 62% (70/113) of the cases withdrawal of the knotted catheters was achieved successfully with different interventional radiological techniques, avoiding the need for surgical exploration. In 32% (36/113) of the patients surgical removal was favoured. Capture with one of the interventional techniques and pulling down the knot into an easily accessible vein to be removed through an open venotomy, was the most common surgical procedure. However, in five cases, an open cardiotomy was required. In seven cases the patient's condition was critical and precluded any surgical procedure, so the knotted catheter was left in situ. The mortality of this event was 8% (9/113). Conclusions: interventional radiological techniques have largely replaced open surgical removal. Knotted catheters may need to be surgically removed when (a) the knot is large in size with many loops, or (b) intracardiac fixing of the knot is encountered.