Closure using a surgical closure device of inadvertent subclavian artery punctures during central venous catheter placement.

Severe complications can and do occur when central venous catheters are inadvertently placed into subclavian arteries. Two cases are discussed that describe how these inadvertent arterial punctures can be closed using the Perclose device (Abbott Laboratories, Redwood City, CA, USA).

Serendipitous discovery and embolization of pulmonary arteriovenous malformations as a lifesaving procedure in a patient with pulmonary emboli.

A patient--with a history of postlaparoscopic deep venous thrombosis and rectus abdominis hematoma--experienced sudden respiratory decompensation requiring mechanical ventilation at an FIO2 of 100%. Initial PaO2 was 32 mm Hg. Pulmonary angiography revealed three unexpected pulmonary arteriovenous malformations as well as pulmonary emboli. Two pulmonary arteriovenous malformations were successfully embolized, and an inferior vena cava filter placed. The PaO2 immediately after the procedure was 458.4 mm Hg.