BRACHIAL-PLEXUS COMPRESSION DUE TO SUBCLAVIAN PSEUDOANEURYSM FROM CANNULATION OF JUGULAR-VEIN HEMODIALYSIS CATHETER

Jugular venous cannulation is generally safer than subclavian cannulat ion, The traumatic complications associated with jugular vein hemodial ysis catheters are rare, A jugular vein, therefore, has become the pre ferred site for hemodialysis catheter insertion, We describe the first case of brachial plexus compression attributable to delayed recogniti on of a right subclavian pseudoaneurysm as a complication of jugular v enous cannulation of hemodialysis catheter, We advocate that any neck swelling, new bruit, and the symptoms of brachial plexopathy after jug ular venous cannulation warrant an intensive investigation to exclude arterial injury, Because delayed diagnosis may lead to a worsened prog nosis in patients with brachial plexus palsy, physicians should exerci se vigilance to detect and manage early the potentially serious and fa tal complications of subclavian artery pseudoaneurysm and brachial ner ve injury. (C) 1998 by the National Kidney Foundation, Inc.