Background: The cuff
catheter is one of the most common routes of vascular access in
hemodialysis patients, while severe complications can occur during cuff
catheter placement, such as
bleeding,
hematoma, and artery or vein damage. During catheterization, brachiocephalic vein perforation associated with a mediastinal lesion is rare. Open chest repair is effective for brachiocephalic vein perforation during
catheter placement, but it entails a risk of potentially lethal
trauma. Interventional treatment can be considered to reduce injury in this context, but relevant reports are limited. Case report: Herein, we describe our experience with a 68-year-old male hemodialyzed patient in whom cuff
catheter vascular access was required for regular
hemodialysis. He complained of mild
pain in the left side of his chest during cuff
catheter placement. The surgeon immediately checked the location of the
catheter. Digital subtraction angiography revealed that the
hemodialysis cuff
catheter had punctured the mediastinal area from the left brachiocephalic vein. The patient was diagnosed with left brachiocephalic vein perforation (d ≈ 5 mm). Fortunately, the brachiocephalic vein perforation was successfully repaired with two embolization microcoils after comprehensive assessment and multidisciplinary consultation. Conclusion: Brachiocephalic vein perforation can be repaired with embolization microcoils during
hemodialysis catheter placement, and this method of interventional treatment is safe and effective.