Endovascular Management of Iatrogenic Neck Vascular Injury after Central Venous Catheterisation

Central venous line placement is a common procedure in both elective and emergency settings across different medical and surgical specialties.The jugular and subclavian approaches are common methods of central venous catheterisation in the neck, which can be performed by traditional methods based on anatomical landmarks or under ultrasound guidance. 1ough rare, iatrogenic neck arterial injury can occur during attempts at central venous catheterisation, leading to serious complications such as arterial perforation with active bleeding, pseudoaneurysm, arteriovenous fistula, arterial dissection, or vascular occlusion resulting in neurological or ischaemic sequelae.Risk factors include obesity, short neck, and emergency catheterisation. 2,3Surgical approaches to repair injured arteries may involve extensive dissection or open-cardiothoracic surgical repair and vascular grafting, and often require general anaesthesia.These may entail prolonged recovery and may not be tolerated by critically ill or elderly patients.Endovascular management of central venous line complications and retrieval of retained indwelling catheters or their components can be a promising firstline treatment option in view of its minimally invasive nature, high success rate with reduced morbidity, and enhanced recovery compared with open surgery.It may be performed under local anaesthesia.Treatment plans for arterial complications should be individualised based on the type of complication, relationship to adjacent vital vessels, angiographic factors, and patients' underlying health conditions.The pros and cons of different endovascular treatment options need to be examined.With increasing use of long-term indwelling venous