Management Of Iatrogenic Subclavian Artery Injury Using Balloon Tamponade: A Case Report

Introduction: Iatrogenic injury to major vessel during central venous catheter insertion is a commonly encountered complication. Different approaches have been described to repair the injured vessel, including open and endovascular technique. Method: We observed a case involving a 47-year-old lady with right subclavian artery injury and hemopneumothorax after insertion of central venous catheter for inotropic support. Result: CT Angiography of the thorax showed malposition of the catheter, piercing the right subclavian artery, with its distal tip within the pleural space at the level of posterior right 7th rib. Digital subtracted angiography (DSA) showed contrast extravasation from proximal right subclavian artery. Temporary balloon tamponade was performed, and the catheter was removed at the same setting. Post balloon tamponade angiogram confirmed no contrast extravasation. Conclusion: Iatrogenic injury to the subclavian artery is rare. Our case demonstrates that the approach of using a balloon to achieve tamponade effect is effective in achieving hemostasis compared to open arterial repair or stenting