Acute Management of Iatrogenic Injury to Vertebral Artery With Central Venous Catheter in a Critically Ill Patient

Abstract

Vertebral artery (VA) injury during catheterization is quite rare given its anatomical position, but can be catastrophic when it is not discovered early on and managed accordingly. A multidisciplinary approach to the management of such injury has to weigh-in the benefits and risks of open surgery versus endovascular intervention. This can be done after thorough assessment of the patient's condition and accessibility of the injured vessel. We report a case of a 90-year-old female admitted as a case of pneumonia associated with decreased level of consciousness. She acquired an iatrogenic injury due to insertion of central venous catheter (CVC) into her dominant right VA as confirmed via CT angiography (CTA). This case report aims to highlight the role of endovascular intervention in the acute management of VA injury in a critically ill patient.