Surgical removal of an ectopic haemodialysis catheter in the brachiocephalic artery: a case report

TL;DR

A 77-year-old woman had an ectopic hemodialysis catheter in her brachiocephalic artery, which was surgically removed due to the risks of complications.

Contribution

This case report highlights the rare complication of arterial catheter placement during hemodialysis and its surgical management.

Findings

An ectopic hemodialysis catheter was placed in the brachiocephalic artery during a routine procedure.

Surgical removal via median sternotomy was performed due to the proximity of the carotid artery and bleeding risks.

The case emphasizes the importance of procedural skills and anatomical understanding to prevent such complications.

Abstract

Percutaneous central vein catheterization is commonly performed to access venous circulation for various clinical indications. However, unintentional arterial puncture may occur which can result in catastrophic complications. We report a case of an inadvertent right brachiocephalic artery cannulation in a 77-year-old lady planned for haemodialysis via a percutaneous internal jugular vein vascular access performed under ultrasound guidance. As an intravascular stent is not favourable in view of the close proximity of the right common carotid artery to the site of puncture as well as the risk of massive bleeding upon simple removal of the catheter, an open surgical removal via a median sternotomy was performed. Acquiring the competency in procedural skills, an understanding of the surgical anatomy and anticipating impending complications are of paramount importance in preventing as well as in mitigating the above complication.

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