Paraplegia: Complication of percutaneous central venous line malposition

Percutaneously inserted central venous lines are usually a safe and effecti ve means of securing prolonged central venous access but can have serious c omplications. One patient who experienced clinically important morbidity re lated to inadvertent malpositioning of a central venous catheter is describ ed. It was inserted via the left saphenous vein into the lumbar venous plex us and resulted in milky cerebrospinal fluid, urine retention, and parapleg ia, Reviewing the literature, only 11 patients with the same malposition we re reported, three of them with percutaneously inserted central venous line s. In these three patients and our patient the left saphenous vein was used . Neurologic sequelae of paraplegia and urine retention were recorded in 25 % (3/12) of patients, The mortality rate approached 42% (5/12) but only two patients were related to catheter misplacement, Although the complication rate is extremely low and difficult to recognize, catheter malposition into the ascending lumbar vein can lead to lethal complications. (C) 2001 by El sevier Science inc. All rights reserved.