Brachial plexus compression due to subclavian pseudoaneurysm from cannulation of jugular vein hemodialysis catheter.
Jugular venous cannulation is generally safer than subclavian cannulation. The traumatic complications associated with jugular vein hemodialysis catheters are rare. A jugular vein, therefore, has become the preferred site for hemodialysis catheter insertion. We describe the first case of brachial plexus compression attributable to delayed recognition of a right subclavian pseudoaneurysm as a complication of jugular venous cannulation of hemodialysis catheter. We advocate that any neck swelling, new bruit, and the symptoms of brachial plexopathy after jugular venous cannulation warrant an intensive investigation to exclude arterial injury. Because delayed diagnosis may lead to a worsened prognosis in patients with brachial plexus palsy, physicians should exercise vigilance to detect and manage early the potentially serious and fatal complications of subclavian artery pseudoaneurysm and brachial nerve injury.
Tarng
D C
DC
Department of Medicine, Veterans General Hospital-Taipei, Taiwan. dctarng@vghtpe.gov.tw
Huang
T P
TP
Lin
K P
KP
D000368:Aged; D017541:Aneurysm, False / Q000150:complications* / Q000175:diagnosis / Q000209:etiology; D001917:Brachial Plexus; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D007601:Jugular Veins; D008297:Male; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology*; D011859:Radiography; D006435:Renal Dialysis / Q000379:methods*; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D014463:Ultrasonography