Brachiocephalic trunk injuries after central venous catheterization: A case series of surgical management and outcomes
Abstract
Introduction and importance Central venous catheter (CVC) placement is a common procedure, particularly in critically ill patients. However, it carries the risk of vascular complications, including rare and severe injuries to the brachiocephalic trunk (BCT). We present a case series of two patients who developed BCT injuries following tunneled CVC placements, highlighting the critical importance of early diagnosis to prevent fatal outcomes. Case presentation An 89-year-old female with chronic renal failure on hemodialysis developed hypotension, tachycardia, and dyspnea after left subclavian catheter placement. CT imaging revealed a BCT injury with hemomediastinum. Despite urgent median sternotomy for repair, she developed transfusion-related acute lung injury and passed away on postoperative day 1. In contrast, a 68-year-old female with multiple myeloma and chronic kidney disease developed swelling and a drop in hemoglobin following left internal jugular catheter placement. Imaging confirmed a left BCT injury without active bleeding, and she underwent successful surgical repair with recovery, being discharged on postoperative day 6. Discussion BCT injury during CVC placement, although rare, is a life-threatening complication. Early diagnosis through imaging, particularly CT, is crucial for guiding surgical intervention. Median sternotomy remains the standard approach for BCT repair, and careful postoperative monitoring is essential, particularly in patients with significant…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.