Dilated internal mammary veins in liver disease – A potential pitfall in central venous cannulation

Vol 7 | Issue 2 | May-August 2021 | Page: 25-26 | Amal F. Sam, Karthik T. Ponnappan, Deepak K. Tempe, Amar Mukund, Vandana


Author: Amal F. Sam [1], Karthik T. Ponnappan [1], Deepak K. Tempe [1], Amar Mukund [2], Vandana Saluja [1]

[1] Department of Anaesthesiology, Institute of Liver and Biliary sciences, New Delhi, India.

[2] Department of Interventional Radiology, Institute of liver and biliary sciences, New Delhi, India.

Address of Correspondence
Dr. Amal Francis Sam,
Department of Anaesthesiology, ILBS, Vasant kunj New Delhi, India.
E-mail: amalfsam@gmail.com.


Dilated internal mammary veins in liver disease – A potential pitfall in central venous cannulation


Abstract

Introduction: Portal hypertension leads to dilation of internal mammary veins. Among the various sites of misplacement of a catheter inserted via the internal jugular vein, misplacement in the internal mammary vein is relatively rare in the general population, when compared to liver disease patients. Catheter misplacement during central venous cannulation can be associated with thrombosis, wedging, erosion, and perforation. The option of replacing or removing the catheter is not always risk-free, particularly with associated coagulopathy. We describe the management of a misplaced CVC which was accessed through the left internal jugular vein and repositioned under fluoroscopic guidance.
Keywords: Central venous catheter, Repositioning of central venous catheter, central venous catheter in left internal mammary vein, portal hypertension, fluoroscopy..


References

1. Roldan CJ, Paniagua L. Central venous catheter intravascular malpositioning: Causes, prevention, diagnosis, and correction. West J Emerg Med. 2015;16(5):658-664. doi:10.5811/westjem.2015.7.26248
2. Philips CA, Arora A, Shetty R, Kasana V. A Comprehensive Review of Portosystemic Collaterals in Cirrhosis: Historical Aspects, Anatomy, and Classifications. Int J Hepatol. 2016;2016. doi:10.1155/2016/6170243
3. Arnez ̌ ZM, Valdatta L, Tyler MP, Planins ̌ek F. Anatomy of the internal mammary veins and their use in free TRAM flap breast reconstruction. Br J Plast Surg. 1995;48(8):540-545. doi:10.1016/0007-1226(95)90041-1
4. Tashjian BC, Schoor ME, Grant M. Cannulation of the Internal Mammary Vein With a Single-Lumen Infusion Catheter in a Patient With Portal Hypertension: A Case Report. A&A Pract. 2019;12(4):122-124. doi:10.1213/XAA.0000000000000956.


How to Cite this Article: Sam AF, Ponnappan KT, Tempe DK, Mukund A, Saluja V | Dilated internal mammary veins in liver disease – A potential pitfall in central venous cannulation | Journal of Anaesthesia and Critical Care Case Reports | May-August 2021; 7(2): 25-26.

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