Misplaced central venous catheter

Case contributed by Liz Silverstone
Diagnosis certain

Presentation

ICU admission for drug overdose.

Patient Data

Age: 40 years
Gender: Male

Later same day

x-ray

Misplaced line.

Day later

x-ray

Left internal jugular central venous catheter in the SVC.

Right subclavian artery stent to prevent haemorrhage.

Case Discussion

Difficult central venous line insertion. 

Initial R carotid artery puncture (not imaged), then R subclavian artery. The tip of the catheter is in the aorta.

CTA brain and neck confirmed line location and no intracerebral complications identified, only minor haemorrhage near the puncture site.

Endovascular stent placed to cover the puncture site.

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