A Treatment Dilemma: Inadvertently Placed Temporary Dialysis Catheter in the Subclavian Artery of a Critically Ill Patient

Each year, more than 5 million Central Venous Catheters (CVCs) are placed in the United States and mechanical complications occur in 19% of them. Despite the advances in the procedure technique and the use of bedside ultrasound, mechanical complications can still occur. Arterial puncture and catheterisation is one of the well-recognised mechanical complications. We report a case of arterial catheterisation of a temporary non-tunneled dialysis catheter in a critically ill patient. The treatment of this complication can be challenging, and, in present case, all treatment options were infeasible. Removal of the CVC from the artery carries a risk of haemorrhage, stroke and pseudoaneurysm, which necessitates a careful consideration of the risks and benefits of each treatment option. Treatment options include manual compression after catheter removal, endovascular and open surgical repair. The present case highlights some of the risk factors associated with arterial catheterisation of CVCs and the limitations of the treatment options.