CTICasesIatrogenic Subclavian Artery Cannulation
Imaging findings
Chest radiograph and CT show a large-bore right internal jugular catheter traversing left of midline and projecting over the aortic arch. The catheter went through-and-through the internal jugular vein to cannulate the subclavian artery, requiring surgical mini-mediastinotomy for removal.
Key takeaways
Inadvertent arterial cannulation is a risk during internal jugular vein placement, especially in volume-depleted patients with collapsed veins. Catheters traversing through the vein into systemic arteries should not be pulled out blindly due to bleeding risk and require surgical or endovascular repair.
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