Management of Inadvertent Arterial Catheterisation Associated with Central Venous Access Procedures.

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title = "Management of Inadvertent Arterial Catheterisation Associated with Central Venous Access Procedures.",
abstract = "OBJECTIVE: This study aims to describe the clinical management of inadvertent arterial catheterisation after attempted central venous catheterisation. METHODS: Patients referred for surgical or endovascular management for inadvertent arterial catheterisation during a 5-year period were identified from an endovascular database, providing prospective information on techniques and outcome. The corresponding patient records and radiographic reports were analysed retrospectively. RESULTS: Eleven inadvertent arterial (four common carotid, six subclavian and one femoral) catheterisations had been carried out in 10 patients. Risk factors were obesity (n=2), short neck (n=1) and emergency procedure (n=4). All central venous access procedures but one had been made using external landmark techniques. The techniques used were stent-graft placement (n=6), percutaneous suture device (n=2), external compression after angiography (n=1), balloon occlusion and open repair (n=1) and open repair after failure of percutaneous suture device (n=1). There were no procedure-related complications within a median follow-up period of 16 months. CONCLUSIONS: Inadvertent arterial catheterisation during central venous cannulation is associated with obesity, emergency puncture and lack of ultrasonic guidance and should be suspected on retrograde/pulsatile catheter flow or local haematoma. If arterial catheterisation is recognised, the catheter should be left in place and the patient be referred for percutaneous/endovascular or surgical management.",
author = "Andreas Pikwer and Stefan Acosta and Tilo K{\"o}lbel and Martin Malina and Bj{\"o}rn Sonesson and Jonas {\AA}keson",
note = "The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Anaesthesiology and Intensive Care (M{\"o}) (013241110), Emergency medicine/Medicine/Surgery (013240200), Unit for Clinical Vascular Disease Research (013242410)",
year = "2009",
doi = "10.1016/j.ejvs.2009.08.009",
language = "English",
volume = "38",
pages = "707--714",
journal = "European journal of vascular and endovascular surgery",
issn = "1532-2165",
publisher = "Elsevier",