PMC4337245_01
Portable AP Chest X-ray showing the fractured access needle within the left anterior chest wall.
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PMC4337245_01_13037_2014_49_Fig1_HTML.jpg
Fig1
Intraoperative tonsil clamp and fluoroscopy indicated the needle positioned medial to the bedside incision, deep to the costoclavicular ligament.
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PMC4337245_01_13037_2014_49_Fig2_HTML.jpg
Fig2
Repeat fluoroscopy revealed the needle to be deep and medial to the costoclavicular ligament, approaching the chest (Figure 2).
A micropuncture access set was used to puncture through the soft tissues on the lateral pectoral region into a thoraco-acromial vein branch which had been exposed laterally on the subclavian vein. A snare device was passed through an 8-French sheath to engage and remove the needle.
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PMC4337245_01_13037_2014_49_Fig3_HTML.jpg
Fig3
The needle and snare were controlled with a sheath, and the needle was retracted successfully in one unit through the venous thoracoacromial branch (Figure 3).