Physician-Modified Fenestrated Endovascular Repair for Iatrogenic Innominate Vein Injury

Kyung Bae Lee; Alyssa J. Pyun; Jonathan Praeger; Kenneth R. Ziegler; Sukgu M. Han

doi:10.5758/vsi.220015

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저자정보: Kyung Bae Lee (Divisions of Vascular Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA, USA) Alyssa J. Pyun (Divisions of Vascular Surgery Keck Medical Center of University of Southern California Los Angeles) Jonathan Praeger (Divisions of Cardiac Surgery Keck Medical Center of University of Southern California Los Angeles C) Kenneth R. Ziegler (Divisions of Vascular Surgery Keck Medical Center of University of Southern California Los Angeles) Sukgu M. Han (Divisions of Vascular Surgery Keck Medical Center of University of Southern California Los Angeles)

저널정보: 대한혈관외과학회 Vascular Specialist International Vascular Specialist International Vol.38 No.2

발행연도: 2022.6

수록면: 22 - 22 (1page)

DOI: 10.5758/vsi.220015

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Iatrogenic innominate vein injuries are rare complications associated with internal jugular venous catheters. These complications are accompanied by high morbidity and mortality rates in patients with severe underlying medical conditions. Without proper treatment, emergency surgery may be needed due to acute cardiac tamponade or hemothorax. Endovascular repair can be advantageous for patients with significant medical comorbidities. Herein, we report the case of a 62-year-old female with an iatrogenic injury to the innominate vein at the subclavian vein and internal jugular confluence due to a malpositioned left internal jugular catheter. A customized fenestrated endograft was positioned with fenestration oriented to the internal jugular vein and a new tunneled catheter was inserted across the fenestration into the superior vena cava upon removal of the malpositioned catheter. In addition, a brachio-basilic arteriovenous fistula was created. At one month followup, the patient had a palpable thrill over the arteriovenous fistula and a functioning tunneled catheter.

#Endovascular procedures #Iatrogenic disease #Brachiocephalic vein #Jugular veins

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Kyung Bae Lee

소속기관 Divisions of Vascular Surgery, Keck Medical Center of University of Southern California, Los Angeles, CA, USA