Avulsion of the right facial vein during double cannulation of the internal jugular vein

Abstract

C OMPLICATIONS assocaated with cannulatlon of the right internal jugular vein (RIJV) include carond artery puncture wath hematoma formatton, RIJV thrombosis, pneumothorax, hemothorax, arrhythmlas, brachial plexus and phrenic nerve injury, and catheter breakage. The incidence of these complications has been reported to be less than 10%. a-I2 Patients at risk for major blood loss and hemodynamic compromise frequently have two central venous catheters inserted in close proxamlty to each other In the RIJV. Little has been reported regarding the complications of the double catheter technique. Withington and Carter descrabed insertion of one 8F catheter into another one while attempting a second cannulation of the RIJV3 2 They were unable to pass a pulmonary artery catheter through either 8F catheter. This case report describes avulsion of the right facial vean after the double cannulatlon of the RIJV.