CTICasesExtra-Lumenal Displacement of SVC Dialysis Catheter
Imaging findings
CT shows a dialysis catheter placed via the left internal jugular vein traversing outside the lateral wall of the superior vena cava into the mediastinum, associated with local gas collections. Follow-up contrast CT confirmed extra-lumenal location, and it was successfully removed under fluoroscopy with IVC safety access.
Key takeaways
Extra-lumenal displacement or perforation of central venous catheters in the mediastinum can be clinically occult without significant hemorrhage if the tract self-seals. Removing these large-bore catheters should be performed under fluoroscopy with safety wire access to balloon the vessel if rupture occurs.
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