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Vascular Medicine
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Vertebral artery dissection following intravascular catheter placement: a case report and review of the literature

Nicholas R Yu

Boston University School of Medicine, Boston, MA, USA

Robert T Eberhardt

Cardiovascular Medicine, Boston Medical Center, Boston, MA, USA, Boston University School of Medicine, Boston, MA, USA

James O Menzoian

Vascular Surgery, Boston Medical Center, Boston, MA, USA, Boston University School of Medicine, Boston, MA, USA

Courtney L Urick

Cardiovascular Medicine, Boston Medical Center, Boston, MA, USA

Joseph D Raffetto

Vascular Surgery, Boston VA Medical Center, Boston, MA, USA, Boston University School of Medicine, Boston, MA, USA, joseph.raffetto{at}med.va.gov

Vertebral artery dissections (VAD) are known to occur as a result of mechanical manipulations of the cervical region, traumatic injury, iatrogenic injury and are also known to arise spontaneously. We report a case of vertebral artery dissection following vertebral artery cannulation during a central line placement and review the literature. The patient underwent intravascular catheter placement that subsequently demonstrated arterial blood. Duplex ultrasound and computed tomographic (CT) scan confirmed vertebral artery cannulation. The catheter was removed at the bedside with pressure, and a subsequent duplex ultrasound scan revealed a vertebral artery dissection. There were no neurological sequelae. The patient was successfully anticoagulated with warfarin but died from unrelated complications. This case report describes the rare iatrogenic event of VAD and reviews its etiology, diagnosis, complications, and management.

Key Words: arterial • catheter • dissection • iatrogenic • vertebral

Vascular Medicine, Vol. 9, No. 3, 199-203 (2004)
DOI: 10.1191/1358863x04vm565cr
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