CTICasesAccidental Subclavian Artery Cannulation and Retrograde Aortic Catheterization
Imaging findings
Chest radiographs of a central line placement show an unusual catheter course, crossing the midline low below the carina and overlaying the aorta. A subsequent chest CT confirms that the catheter missed the internal jugular vein, entered the subclavian artery, and coursed retrogradely into the ascending aorta.
Key takeaways
Accidental arterial cannulation is a serious complication of central venous access procedures. When a catheter follows an atypical anatomical course on a radiograph, arterial placement must be suspected, and the catheter should not be used or removed without surgical or endovascular consultation to prevent catastrophic hemorrhage or stroke.
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