Unintentional arterial puncture during cephalic vein cannulation: case report and anatomical study.
BACKGROUND
The cephalic antebrachial vein is often used for venous access. However, superficial radial arteries of the forearm are known and unintentional arterial puncture can result from attempts to cannulate the lateral veins of the arm.


METHODS
Accidental puncture of a superficial radial artery during peripheral venous cannulation prompted us to study the anatomy of 26 specimens and to assess the relationship between the radial artery and the cephalic vein in the forearm.


RESULTS
In two cases, we found accessory branches of the radial artery close to the cephalic forearm vein. Venous cannulation at the lateral wrist carries a small risk of arterial puncture if arterial anomalies are present.


CONCLUSIONS
If venous cannulation is attempted at the radial side of the wrist, palpation for pulsation should reduce the danger of arterial puncture.
Lirk
P
P
Department of Anesthesiology and Critical Care Medicine, Medical University of Innsbruck, Austria. plirk@mcw.edu
Keller
C
C
Colvin
J
J
Colvin
H
H
Rieder
J
J
Maurer
H
H
Moriggl
B
B
D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D005260:Female; D005542:Forearm / Q000098:blood supply; D006225:Hand / Q000098:blood supply; D006801:Humans; D017534:Radial Artery / Q000002:abnormalities / Q000293:injuries*; D014680:Veins / Q000033:anatomy & histology; D014950:Wounds, Penetrating / Q000209:etiology*