A Case of Inadvertent Carotid Arterial Cannulation and Its Successful Closure with a Percutaneous Closure Device

Iatrogenic carotid artery cannulation is a rare but potentially devastating complication of central venous catheterization. We present the case of an 80-year-old male with coronary artery disease who presented with syncope in the setting of complete heart block. Prior to the planned placement of a permanent pacemaker, he underwent temporary transvenous pacemaker insertion via the right internal jugular vein. Despite the use of ultrasound, his right common carotid artery was inadvertently cannulated and dilated. This was only identified after the application of a pressure transducer. As he had a prohibitive risk for open surgical repair, his right common carotid artery was then repaired less invasively with the use of a Perclose Proglide percutaneous closure device (Abbott Vascular, Inc., Santa Clara, CA, USA), leading to a successful repair without any adverse neurological outcome. A temporary pacemaker was eventually placed via the right femoral vein approach. As the patient had an ejection fraction of 35%, he eventually underwent a biventricular implantable cardioverter-defibrillator placement successfully before being discharged home without further complications. To the best of our knowledge, our case report is only the fourth case in the literature to report the off-label use of a suture-mediated closure device to repair inadvertent carotid arterial cannulation with a good outcome.