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BJA Advance Access originally published online on March 5, 2004
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British Journal of Anaesthesia, 2004, Vol. 92, No. 5 740-742
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Unintentional arterial puncture during cephalic vein cannulation: case report and anatomical study{dagger}

P. Lirk*,1,3, C. Keller1, J. Colvin1, H. Colvin3, J. Rieder1, H. Maurer2 and B. Moriggl2

1 Department of Anesthesiology and Critical Care Medicine and 2 Institute of Anatomy, Histology & Embryology, Medical University of Innsbruck, Austria. 3 Department of Anesthesiology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA

*Corresponding author at Medical College of Wisconsin. E-mail: plirk@mcw.edu.
{dagger}This work should be attributed to the Department of Anesthesiology and Critical Care Medicine, University of Innsbruck, Austria.

Background. The cephalic antebrachial vein is often used for venous access. However, superficial radial arteries of the forearm are known and unintentional arterial puncture can result from attempts to cannulate the lateral veins of the arm.

Methods. Accidental puncture of a superficial radial artery during peripheral venous cannulation prompted us to study the anatomy of 26 specimens and to assess the relationship between the radial artery and the cephalic vein in the forearm.

Results. In two cases, we found accessory branches of the radial artery close to the cephalic forearm vein. Venous cannulation at the lateral wrist carries a small risk of arterial puncture if arterial anomalies are present.

Conclusions. If venous cannulation is attempted at the radial side of the wrist, palpation for pulsation should reduce the danger of arterial puncture.

Br J Anaesth 2004: 92: 740–2


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