Key result
Left IJV dialysis catheter placement mimics arterial cannulation due to adjacent AV graft.
Why the study?
Misinterpretation of ultrasound-guided temporary hemodialysis catheter placement in the left internal jugular vein can occur due to the presence of a functional left brachio-axillary arteriovenous graft, leading to pseudo-arterial placement diagnosis.
Case Report (n=1)
The presence of an ipsilateral functional arteriovenous graft can cause a central venous catheter in the internal jugular vein to mimic arterial misplacement due to arterialized venous blood.
Recognition of this AV graft mimic may prevent misdiagnosis of arterial placement; leaves open its prevalence and optimal confirmation strategies in complex access.
. in 1969 as the safest approach. Carotid artery puncture had an incidence rate of 4-6% before ultrasound guidance. We encountered an unexpected sequence of events following the ultrasound-guided placement of a temporary HD catheter in the left IJV. The postprocedure chest radiograph was misinterpreted as an arterial misplacement, the blood return was correspondingly bright red, and simultaneous blood gas analyses from the left IJV catheter and a right radial artery were near mirror images. Subsequently, a transducer to the catheter showed a clearly venous waveform with a pressure of 40 mmHg. Thus, it was realized that the cacophony of missteps, misjudgments, and misinterpretations was due to the contiguous presence of a functional left brachio-axillary arteriovenous (AV) graft. To our knowledge, this is the first such report of this phenomenon of a pseudo-arterial central venous catheter placement in the IJV.
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Onuigbo et al. (2019) conducted a case report in Hemodialysis catheter placement (n=1). Ultrasound-guided placement of a temporary hemodialysis catheter in the left internal jugular vein was evaluated. Ultrasound-guided placement of a temporary hemodialysis catheter in the left internal jugular vein mimicked an arterial misplacement due to a contiguous functional left brachio-axillary AV graft.
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