Vertebral artery dissection following intravascular catheter placement: a case report and review of the literature.
Vertebral artery dissections (VAD) are known to occur as a result of mechanical manipulations of the cervical region, traumatic injury, iatrogenic injury and are also known to arise spontaneously. We report a case of vertebral artery dissection following vertebral artery cannulation during a central line placement and review the literature. The patient underwent intravascular catheter placement that subsequently demonstrated arterial blood. Duplex ultrasound and computed tomographic (CT) scan confirmed vertebral artery cannulation. The catheter was removed at the bedside with pressure, and a subsequent duplex ultrasound scan revealed a vertebral artery dissection. There were no neurological sequelae. The patient was successfully anticoagulated with warfarin but died from unrelated complications. This case report describes the rare iatrogenic event of VAD and reviews its etiology, diagnosis, complications, and management.
Yu
Nicholas R
NR
Vascular Surgery, Boston Medical Center, Boston VA Medical Center Boston, MA, USA.
Eberhardt
Robert T
RT
Menzoian
James O
JO
Urick
Courtney L
CL
Raffetto
Joseph D
JD
D002405:Catheterization, Central Venous / Q000009:adverse effects*; D020878:Device Removal; D006801:Humans; D007601:Jugular Veins / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000601:surgery; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex; D020217:Vertebral Artery Dissection / Q000175:diagnosis* / Q000209:etiology*