Santral Venöz Kateterizasyon Girişimi Sonrasında Gelişen Psödoanevrizma ve Endovasküler Tedavisi

Year 2021, Volume: 4 Issue: 4, 149 - 152, 29.12.2021

Berna Keskin , Erdem Birgi , Onur Ergun , Azad Hekimoğlu , Erdi Tangobay Baki Hekimoğlu

https://doi.org/10.54996/anatolianjem.1004014

Abstract

Amaç: Olgumuzda acil serviste internal juguler ven (IJV) kateterizasyonu sırasında arteriyal ponksiyona sekonder gelişen tiroservikal trunkus kaynaklı psödoanevrizma ve endovasküler tedavisi anlatılmakta olup amacımız nadir görülen bu komplikasyonun tanınması ve güvenli tedavisinin tartışılmasıdır.

Olgu: Acil servisimize başvuran 21 yaşında erkek hastaya acil diyaliz kararı alınmış. Geçici hemodiyaliz kateteri takılması amacıyla acil serviste sol IJV’den girişim denenmiş. İğne girişi sonrası gelen pulsatil kan nedeniyle iğne çekilmiş. Basıya rağmen boyunda hızlı büyüyen şişlik meydana gelen hasta radyoloji birimimize ileri inceleme amacıyla yönlendirildi. Birimimizde yapılan tetkikler sonucu tiroservikal trunkus kaynaklı psödoanevrizma teşhisi konuldu. Yapılan anjiografide koil embolizasyon ile endovasküler tedavisi tamamlandı.

Sonuç: IJV kateterizasyonu sonrasında boyunda üfürüm olsun veya olmasın şişlik gelişen hastalarda psödoanevrizmanın da akla gelmesi ve Doppler USG ile araştırılması gerekmektedir. Gelişen psödoanevrizmanın tedavisinde endovasküler koil embolizasyon güvenilir ve efektif bir yöntem olarak ilk planda tercih edilmelidir.

Keywords

Santral venöz kateterizasyon, psödoanevrizma, endovasküler tedavi

Pseudoaneurysm After Central Venous Catheterization Intervention and Endovascular Treatment

Abstract

Aim: In our case, the endovascular treatment of thyrocervical truncus-derived pseudoaneurysm secondary to arterial puncture during internal jugular vein (IJV) catheterization in the emergency department is described. Our aim is to discuss the diagnosis and safe treatment of this rare complication.

Case: Emergency dialysis decision was taken for a 21-year-old male patient who applied to our emergency department. Intervention from the left IJV was attempted in the emergency room to insert a temporary hemodialysis catheter. The needle was withdrawn due to pulsatile blood coming after needle insertion. The patient, who had a rapidly growing swelling in the neck despite the pressure, was referred to our radiology unit for further examination. As a result of the examinations performed in our unit, a diagnosis of pseudoaneurysm originating from the thyrocervical trunk was made. Endovascular treatment with coil embolization was completed in angiography.

Conclusion: Pseudoaneurysm should also be considered in patients who develop swelling with or without a neck murmur after IJV catheterization and should be investigated with Doppler USG. Endovascular coil embolization should be preferred as a safe and effective method in the treatment of developing pseudoaneurysm.

Keywords

Central venous catheterization, pseudoaneurysm, endovascular treatment

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