Introduction Incidental arterial puncture is one of the main complications associated with central venous catheter placement. Manual compression to achieve hemostasis in subclavian and carotid artery punctures is often ineffective because of the anatomical arterial position. Accidental cannulation has traditionally been treated with open surgery or endovascular treatment, but such procedures are not exempt from complications. Objectives Report our experience with ultrasound-guided off-label use of Perclose ProGlide (Abbott Vascular Inc., Santa Clara, CA, USA) in patients with iatrogenic arterial cannulation. Methods Six unstable patients with accidental arterial catheterization during placement of a central venous catheter: five of them in the subclavian artery and one in the right common carotid artery. Ultrasound-guided percutaneous closure was performed at bedside using a Perclose ProGlide (Abbott Vascular Inc., Santa Clara, CA, USA). Results All patients underwent duplex ultrasound 6, 12, 24, and 48 h postprocedure, and no complications associated with percutaneous closure (embolism, ischemia, stenosis, or arterial occlusion, bleeding, pseudoaneurysm, etc.) were described. Conclusions Accidental artery puncture during central venous catheterization is an uncommon situation but can be effectively managed by using percutaneous vascular closure device. It is a reliable alternative that should be considered as a first-line approach before endovascular or open surgery, specially in patients with unstable conditions in which it is possible to be performed without transfer to an operation room.

中文翻译：

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Proglide 经皮闭合装置在医源性动脉导管插入术中的超说明书使用：我们的经验

简介 意外动脉穿刺是与中心静脉导管放置相关的主要并发症之一。由于解剖动脉位置的原因，在锁骨下动脉和颈动脉穿刺中手动加压以实现止血通常是无效的。意外插管传统上通过开放手术或血管内治疗进行治疗，但此类手术也不能免除并发症。目的 报告我们在超声引导下超说明书使用 Perclose ProGlide（Abbott Vascular Inc.，Santa Clara，CA，USA）在医源性动脉插管患者中的经验。方法 6 例在放置中心静脉导管时意外插入动脉插管的不稳定患者：其中 5 例位于锁骨下动脉，1 例位于右侧颈总动脉。使用 Perclose ProGlide (Abbott Vascular Inc., Santa Clara, CA, USA) 在床边进行超声引导下经皮缝合。结果所有患者术后6、12、24、48 h均接受双工位超声检查，未见经皮封堵相关并发症（栓塞、缺血、狭窄或动脉闭塞、出血、假性动脉瘤等）。结论 中心静脉置管术中意外穿刺动脉是少见的情况，但可以通过使用经皮血管闭合装置进行有效处理。它是一种可靠的替代方法，应被视为血管内或开放手术前的一线方法，特别是对于病情不稳定且无需转移到手术室即可进行手术的患者。