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Iatrogenic Subclavian Artery Dissection and Vertebral Occlusion

Imaging findings

Chest and neck CT following a misplaced central venous line placement show dissection of the right subclavian and common carotid arteries, occlusion of the right vertebral artery, and a large mediastinal hematoma. Brain MRI confirms acute embolic infarcts in the cerebellum.

Key takeaways

Misplaced internal jugular catheters can inadvertently enter the subclavian or carotid arteries, leading to arterial dissection, hematoma, and thromboembolic stroke. Care must be taken to verify line placement using ultrasound or fluoroscopy.

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