title: Early transection of a central venous catheter in a sedated ICU patient.
abstract: We report transection and embolization to the heart of a subclavian venous catheter in an immobilized and mechanical ventilated patient. The catheter tip was retrieved using a percutaneous method via the left femoral vein. Mechanical compression of the subclavian venous catheter at the costoclavicular area is termed pinch-off syndrome. It can be recognized by intermittent difficulties with drug injection, and chest wall swelling at the insertion site. The diagnosis can be confirmed by chest radiography with or without contrast administration. A more lateral approach of the subclavian vein is advocated to prevent compression.
authors.affiliation: Department of Anesthesiology and Intensive Care, St Antonius Hospital PO Box 2500, 3430 EM Nieuwegein, The Netherlands. j.de.graaff@antonius.net
authors.forename: J C
authors.initials: JC
authors.lastname: de Graaff
authors.forename: L J
authors.initials: LJ
authors.lastname: Bras
authors.forename: J A
authors.initials: JA
authors.lastname: Vos
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation*; D003422:Critical Care; D004617:Embolism / Q000209:etiology; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial