2023 Volume 51 Issue 3 Pages 244-250
We report a case in which a central venous catheter (CVC) misplaced in the vertebral artery during insertion was surgically removed. A 70-year-old man was suspected of having a pancreatic abscess based on computed tomography (CT). The patient was initially treated for it at another department. Moreover, as part of the treatment, the CVC was placed under echocardiographic guidance. However, while placing the CVC, the catheter was erroneously inserted into the vertebral artery; therefore, he was referred to our department for retrieval. Magnetic resonance imaging (MRI) showed right thalamic and occipital cerebral infarctions. CT angiography (CTA) demonstrated that the catheter was inserted approximately 5 mm distal to the bifurcation of the brachiocephalic and vertebral arteries, and the catheter tip was located in the brachiocephalic artery. Removing the catheter posed risks such as hemorrhage, cerebral embolism, and arteriovenous fistulas. Therefore, to prevent the aforementioned risks, we chose a surgical intervention to remove the catheter using a microscope. The postoperative course was uneventful, and no complications occurred. This case demonstrates that surgical removal of CVC is effective and should be considered to avoid the risk of complications.
