1Izzat Abdulla Basahai, 1Muhammed Sharahili, 1Muhammed Ouhlous, 1Bader Al Ahaideb

1King Saud Medical City, Riyadh, Saudi Arabia

 

Case Report:

We report two cases of inadvertent subclavian arterial line insertions in ICU patients. Suture mediated closure device ( Perclose Proglide) were used successfully in both cases .

Initially, in both cases the arterial position of catheters was discovered immediately after insertion. Pulsating arterial flow and Arterial blood gases suggested intraarterial positions. 

CT chest confirmed catheter positions and excluded bleeding and thrombosis.

Removal was performed by Interventional Radiologist, diagnostic angiograms were performed prior to and after removal.

One case had a technical failure of the device and second closure device was applied successfully. 

The second patient was positive COVID-19  patient and required special contact precautions.

Both patients had a dominant right vertebral arteries. Stenting was a difficult option in these cases due to close proximity of vertebral arteries.  Surgery was a difficult far invasive option in these fragile patients.

Both cases were followed after the procedure clinically and by chest xray to confirm successful non-complicated removal.