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BJA Advance Access published online on September 21, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael255
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted August 14, 2006

Case Report

Early transection of a central venous catheter in a sedated ICU patient

J. C. de Graaff 1 *, L. J. Bras 1, and J. A. Vos 2

1 Department of Anesthesiology and Intensive Care, St Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, The Netherlands
2 Department of Radiology, St Antonius Hospital, PO Box 2500, 3430 EM Nieuwegein, The Netherlands

* To whom correspondence should be addressed.
J. C. de Graaff, E-mail: j.de.graaff{at}antonius.net


  Abstract

We report transection and embolization to the heart of a subclavian venous catheter in an immobilized and mechanical ventilated patient. The catheter tip was retrieved using a percutaneous method via the left femoral vein. Mechanical compression of the subclavian venous catheter at the costoclavicular area is termed pinch-off syndrome. It can be recognized by intermittent difficulties with drug injection, and chest wall swelling at the insertion site. The diagnosis can be confirmed by chest radiography with or without contrast administration. A more lateral approach of the subclavian vein is advocated to prevent compression.

Keywords: complications, veins, subclavian, cannulation.
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