[Vascular injuries during percutaneous catheterization of the lower neck in children].

Four cases of vascular injuries of subclavian artery in children are reported after 414 percutaneous catheterization between 1980 and 1986. The first case reported is a 2 month old child with a right subclavian aneurysm after punction, witch be treated by a successful resection-anastomosis. Three others children, 12, 13, and 14 years old have been catheterized by a jugular approach for one and by a subclavian approach in the others. In this three cases the diagnosis was made by an important hemothorax requiring a drainage. In one case, the recovery was obtain only by drainage, in the two others a surgical approach was necessary with a suture of the subclavian artery in one and a ligation in the other case. The diagnosis of these vascular lesion is difficult = an hemothorax must be drained quickly and a persistent bleeding require a surgical treatment by a cervical route associated with a cleidotomy for the subclavian control. All catheterization in children must be realized by operator with a good practice and an adapted material. The jugular route must be preferred to the subclavian route in children.