title: Remove or not, that is the question: A case report on carotid artery cannulation during indwelling venous hemodialysis catheter.
abstract: A 58-year-old woman visited the emergency department for acute occlusion of arteriovenous fistula. One session of hemodialysis was scheduled via temporary venous hemodialysis catheter before thrombectomy. Unfortunately, neck arterial cannulation was discovered after complete placement of catheter. The catheter was removed immediately but bleeding could not be stopped. Pseudoaneurysm over the right carotid artery was proved by angiography and repaired by graft stent. Arterial cannulation during venous hemodialysis catheter insertion is a rare but serious complication and there is no standard response recommended. Immediate removal of the misplaced hemodialysis catheter might not be the best choice. We suggest to leave the misplaced catheter in artery until further intervention in consideration of complications and repair access. Every hemodialysis center should standardize responses to arterial cannulation during venous hemodialysis catheter indwelling, especially carotid puncture happens, according to the medical facility.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Yen
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Chiu
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Hung-Chun
authors.initials: HC
authors.lastname: Chen
mesh_terms: D017536:Carotid Artery, Common / Q000601:surgery*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*
keywords: Hemodialysis; arterial cannulation; indwelling catheter