title: Endovascular management of type B aortic dissection after attempted central venous catheterization.
abstract: A 41-year-old woman, status postmastectomy for breast cancer had an attempted 8-F left subclavian vein chemotherapy port placed in her. She developed severe upper back pain radiating to the left shoulder. A computed tomographic scan and angiography revealed catheter placement in the left subclavian artery and a type B aortic dissection. A thoracic stent-graft was used to treat the aortic dissection. While removing the catheter, a covered stent was deployed to seal the arterial puncture and a balloon-expandable stent was placed over a persistent subclavian dissection. This case illustrates an example of the feasibility of endovascular management to treat serious iatrogenic access complications.
authors.affiliation: Division of Vascular Surgery, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Gautam V
authors.initials: GV
authors.lastname: Shrikhande
authors.forename: Sikandar Z
authors.initials: SZ
authors.lastname: Khan
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Meltzer
authors.forename: Katherine
authors.initials: K
authors.lastname: Gallagher
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Morrissey
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D001027:Aortography; D001416:Back Pain / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008408:Mastectomy; D010690:Phlebography; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013350:Subclavian Vein / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents