Inadvertent subclavian artery catheter placement complicated by stroke: endovascular management and review.
BACKGROUND
Removal of large-bore venous catheters misplaced within the subclavian artery risks significant hemorrhage due to the noncompressible entry site. Comorbidities in these patients often make traditional surgical approaches prohibitive.


METHODS
We present a case of inadvertent subclavian artery placement of a central venous catheter complicated by thromboembolic stroke, illustrate treatment with a combination of percutaneous closure and temporary balloon tamponade, and review the endovascular management of this unusual problem.


CONCLUSIONS
Endovascular treatment of inadvertent subclavian artery catheterization appears to be a reasonable option, and its less-invasive nature may be beneficial for patients in whom the underlying disease initially required central venous access.
Jahromi
Babak S
BS
Department of Neurosurgery, Millard Fillmore Gates Hospital, Kaleida Health, Buffalo, New York 14209, USA.
Tummala
Ramachandra P
RP
Levy
Elad I
EI
D015901:Angiography, Digital Subtraction; D000925:Anticoagulants / Q000627:therapeutic use; D021721:Balloon Occlusion / Q000295:instrumentation; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002533:Cerebral Angiography; D020878:Device Removal; D038524:Diffusion Magnetic Resonance Imaging; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D006489:Hemostatic Techniques / Q000295:instrumentation; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D011677:Punctures; D015641:Radiography, Interventional; D020521:Stroke / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D013348:Subclavian Artery / Q000293:injuries* / Q000473:pathology; D013923:Thromboembolism / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016896:Treatment Outcome
D000925:Anticoagulants; D006493:Heparin