Iatrogenic vascular traumas are increasing and their proportion exceeds 40% of all vascular injuries. We report on a rare case of iatrogenic injury of the brachiocephalic arterial trunk during surgical intervention due to postirradiation arteriopathy, which was successfully treated with a silver prosthesis graft. A 58-year-old male underwent surgery for metastases of papillary carcinoma of the thyroid gland, located in lymph nodes adjacent to the right common carotid artery and right subclavian artery. During the surgery, there was an intraoperative injury of the brachiocephalic arterial trunk that included spontaneous rupture and tear of the subclavian and common carotid artery, as the result of extreme fragility of the arterial wall, probably due to the previous irradiation therapy. Emergency sternotomy and clavicle resection were followed by blood flow reconstruction by use of an Y prosthesis that was applied for terminoterminal anastomosis between the brachiocephalic trunk to common carotid artery and subclavian artery. The authors concluded that irradiation therapy may lead to progressive arteriopathy in affected arteries.
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Indian J Thorac Cardiovasc Surg
February 2025
Department of Paediatric Cardiothoracic Surgery, Sri Satya Sai Sanjeevani Centre for Child Heart Care and Training in Pediatric Cardiac Skills, Atal Nagar- Nava Raipur 492101, Chhattisgarh Atal Nagar-Nava Raipur, India.
Anomalous brachiocephalic vein (ABCV) is a rare entity of head and neck venous channel variations and malformations. Amongst the five subtypes of ABVC, double left brachiocephalic vein (DLBCV) is the rarest. We present the case of a 1-year-11-month-old syndromic child, who had global developmental delay (GDD) with Sprengel deformity and failure to thrive (suspected Klippel Feil phenotype), who presented to us for the cardiac evaluation.
View Article and Find Full Text PDFCureus
December 2024
Orthopedic Department, King Fahad Medical City, Riyadh, SAU.
Posterior sternoclavicular joint (SCJ) dislocation is a rare but potentially life-threatening injury due to its proximity to critical mediastinal structures. Early diagnosis and prompt management are essential to prevent severe complications such as vascular or respiratory compromise. We report a case of a 23-year-old male who presented to our emergency department five days after a high-energy motor vehicle accident with isolated, closed posterior dislocation of the SCJ.
View Article and Find Full Text PDFJ Vasc Access
December 2024
St. Joseph's Regional Medical Center, Paterson, NJ, USA.
Background: The decision to place a subcutaneously tunneled catheter is an infection prevention strategy for long term venous access allowing the proceduralist to access a vein and relocate the catheter exit site to a region on the body where care and maintenance can be safely performed. Subcutaneously tunneled centrally inserted dialysis catheter (ST-CIDC) placement is commonly performed in patients with renal disease and is traditionally performed with fluoroscopy in the interventional radiology suite or the operating theater. However, today's interventional radiologists and surgeons perform advanced invasive procedures that can be time-consuming resulting in delays in the scheduling of elective tunneled catheter placements.
View Article and Find Full Text PDFEur J Case Rep Intern Med
November 2024
Intensive Care Department, Hospital Sousa Martins, Guarda, Portugal.
Introduction: Central venous catheterisation (CVC) is a commonly performed procedure in clinical practice. Although usually safe, complications can arise such inadvertent vascular lesion. This report is of a case of left brachiocephalic vascular lesion due to a subclavian catheter, thus raising awareness about this potential complication, which is not always immediately recognised.
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
A central venous catheter (CVC) was placed in the left internal jugular vein of a woman in her late 20s, who was admitted to our intensive care unit during the management of her abdominal wall sepsis. Two days later, the patient had pain at the insertion site. Check aspiration revealed the presence of aspirate from all the lumens except the distal lumen.
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