CTICasesAccidental Subclavian Artery Catheterization
Imaging findings
Chest radiograph and subsequent CT demonstrate a malpositioned central venous catheter. The catheter was introduced via a subclavian approach but runs abnormally medially and projects over the aortic arch. CT confirms the catheter enters and traverses the subclavian artery, with its tip terminating in the descending thoracic aorta.
Key takeaways
Accidental arterial puncture is a known complication of central venous line insertion, particularly in the subclavian position where ultrasound guidance can be challenging. An abnormally medial or downward course of the catheter on radiograph should raise immediate suspicion for arterial placement, and confirmation is obtained via arterial pressure transduction or CT prior to using the line.
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