RIGHT BRACHEOCEPHALIC VEIN LACERATION DURING SUBCLAVIAN VEIN CANNULATION: A CASE REPORT.

Abstract

Central venous catheter (CVC) insertion is commonly used in critically ill patients and those undergoing major surgery for invasive monitoring and aggressive haemodynamic resuscitation. Mechanical complications most often occur during insertion of the catheter. We report a rare complication of right brachiocephalic vein laceration despite an uneventful procedure of subclavian CVC insertion on same side. The stiff dilator sheath introduced over the guidewire then perforated the wall of the brachiocephalic vein. This was diagnosed on thoracotomy, which was the first phase of the planned surgery. Subsequently central line was removed and the laceration was successfully repaired without significant blood loss.

Keywords: Bracheocephalic vein laceration, central venous catheter insertion, subclavian vein, superior vena cava.