CTICasesAccidental Right Subclavian Artery Catheterization
Imaging findings
Chest radiography in an ICU patient shows a central venous catheter placed via a right subclavian approach taking an abnormally high, medial course crossing the midline, suggesting arterial placement. Non-contrast and contrast-enhanced computed tomography confirm the catheter enters the right subclavian artery and extends into the brachiocephalic artery. Follow-up computed tomography after catheter removal demonstrates minimal surrounding hematoma and no significant stenosis or pseudoaneurysm.
Key takeaways
Subclavian artery catheterization is a known complication of blind central venous access. If arterial placement is suspected, the catheter should not be simply pulled out due to the high risk of hemorrhage or pseudoaneurysm; instead, cross-sectional imaging should be performed, and vascular surgery should guide removal, potentially utilizing endovascular techniques such as balloon occlusion.
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