CTICasesMisplaced Swan-Ganz Catheter via Left Superior Intercostal Vein
Imaging findings
Historical radiograph shows a Swan-Ganz catheter placed via the left subclavian vein taking an unusual posteromedial course. Fluoroscopy demonstrates the catheter coursing through the left superior intercostal vein, accessory hemiazygos vein, crossing to the azygos vein, and terminating in the SVC.
Key takeaways
Misplacement of central venous lines or Swan-Ganz catheters into the left superior intercostal or hemiazygos systems can occur via a left-sided approach. Understanding this venous anatomy prevents misinterpretation of the catheter course as extravascular or arterial.
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