Incidence of in-advertent carotid artery puncture during pulmonary artery catheterization using right internal jugular vein

Pulmonary artery catheter (PAC) can be placed from all of the central venous catheterization sites, but most anaesthetists prefer right internal jugular vein (RIJV). Inadvertent carotid artery puncture during RIJV cannulation is not uncommon. We prospectively analyzed its incidence during pulmonary artery catheterization in 125 adult patients undergoing various open heart surgical procedures. We were able to cannulate the IJV in first attempt in 72% while it took two attempts in 16.80% and three in 04.80% of the patients. Failure to cannulate IJV was there in 06.40% of patients, while the incidence of carotid artery puncture was 08.80%. None of these patients suffered any morbidity associated with carotid artery puncture, however mild neck haematoma was seen in 07.02% of the patients.