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British Journal of Anaesthesia, 2001, Vol. 87, No. 2 302-305
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Ruptured superior thyroid artery from central vein cannulation: treatment by coil embolization

V. Jeganath1, J. G. McElwaine2 and P. Stewart2

1Department of Cardiothoracic Anaesthesia, Freeman Hospital, High Heaton, Newcastle-upon-Tyne NE7 7DN, UK. 2Directorate of Anaesthesia and Intensive Care, City General, Newcastle Road, Stoke-on-Trent ST4 6QG, UK.*Corresponding author

Central vein cannulation is associated with several complications, some of which may be fatal. This case report describes a life-threatening complication after insertion of a central venous line. An obese female patient with end-stage renal failure due to nephrotic syndrome developed a huge neck swelling and sudden airway obstruction after attempted cannulation of the internal jugular vein for haemodialysis. Tracheal intubation was achieved using a gum-elastic bougie. Investigations revealed abnormal blood clotting. The coagulopathy was treated, but the neck swelling continued to increase in size. Carotid angiography showed a ruptured right superior thyroid artery. The haemorrhage was controlled by coil embolization of the artery. This case report demonstrates the usefulness of the gum-elastic bougie in the presence of a difficult airway and of interventional radiology in the management of vascular accidents.

Br J Anaesth 2001; 87: 302–5


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