We present a life-threatening case of hemothorax resulting from right brachiocephalic vein perforation during right internal jugular vein catheterization. We considered that the guidewire had punctured the right brachiocephalic vein extraluminally and the catheter inserted over the guidewire had enlarged the size of the perforation. Despite the use of proper technique, an angle-tip guidewire may perforate the venous wall. Therefore, when there is negative aspiration after central venous catheterization, it is important to perform an emergency chest radiograph before proceeding with surgery; it is also important not to use an angle-tip guidewire.
Central venous catheterization Guidewire Hemothorax
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Domino KB, Bowdle TA, Posner KL, Spitellie PH, Lee LA, Cheney FW. Injuries and liability related to central vascular catheters. A closed claims analysis. Anesthesiology. 2004;100:1411–1418.PubMedCrossRefGoogle Scholar
Kulvatunyou N, Heard SO, Bankey PE. A subclavian artery injury, secondary to internal jugular vein cannulation, is a predictable right-sided phenomenon. Anesth Analg. 2002;95:564–566.PubMedCrossRefGoogle Scholar
Jankovic Z, Boon A, Prasad R. Fatal haemothorax following largebore percutaneous cannulation before liver transplantation. Br J Anaesth. 2005;95:472–476.PubMedCrossRefGoogle Scholar
Oropello JM, Leibowitz AB, Manasia A, Guidice RD, Benjamin E. Dilator-associated complications of central vein catheter insertion: possible mechanisms of injury and suggestions for prevention. J Cardiothorac Vasc Anesth. 1996;10:634–637.PubMedCrossRefGoogle Scholar
Beilin Y, Bronheim D, Mandelbaum C. Hemothorax and subclavian artery laceration during “J” wire change of a right internal jugular vein catheter. Anesthesiology. 1998;88:1399–1400.PubMedCrossRefGoogle Scholar
Powell H, Beechey APG. Internal jugular catheterization: case report of a potentially fatal hazard. Anaesthesia. 1990;45:458–459.PubMedCrossRefGoogle Scholar
Jain U, Shah KB, Belusko RJ, Kumar P, Foy BK, Montoya A, Rao TL. Subclavian artery laceration and acute hemothorax on attempted internal jugular vein cannulation. J Cardiothorac Vasc Anesth. 1991;5:608–610.PubMedCrossRefGoogle Scholar