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BJA Advance Access published online on March 5, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh118
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted December 12, 2003

Short Communication

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

P. Lirk 1*, C. Keller 2, J. Colvin 2, H. Colvin 3, J. Rieder 2, H. Maurer 4, B. Moriggl 4

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

* To whom correspondence should be addressed. E-mail: plirk{at}mcw.edu.


  Abstract

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.

Keywords: Keywords: arteries, radial; forearm; veins, cannulation; veins, cephalic


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