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Updated: May 2, 2026
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The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
Published on: December 23, 2014
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Transpleural central venous catheter discovered during thoracotomy
Ashima Malhotra1, Prakash Sharma2, Ashvini Kumar2
1Department of Anesthesia, BLK Superspeciality Hospital, New Delhi, India.
Summary
An uncommon complication of subclavian central venous catheterization occurred, where the catheter traversed the pleural cavity despite normal readings. This subclavian catheterization issue required surgical intervention for removal and bleeding control.
Area of Science:
- Medical procedures
- Thoracic surgery
- Vascular access
Background:
- Central venous catheters (CVCs) are essential for patient monitoring and treatment.
- Subclavian catheterization is a common CVC insertion technique.
- Complications, though rare, can arise from CVC placement.
Observation:
- A patient undergoing thoracotomy revealed an unusual complication of prior subclavian central venous catheterization.
- The central venous catheter was inserted via the left infraclavicular route under general anesthesia.
- Despite normal central venous tracing and blood aspiration, the catheter was found to have traversed the pleural cavity.
Findings:
- The misplaced central venous catheter within the pleural cavity was an unexpected finding during thoracotomy.
- The catheter's presence in the pleural space occurred despite a satisfactory central venous tracing.
- Surgical removal of the catheter was necessary, leading to the identification and surgical management of bleeding at the puncture sites.
Implications:
- This case highlights the potential for unexpected CVC malpositioning, even with seemingly normal monitoring parameters.
- Thoracotomy can uncover previously undiagnosed complications of central venous catheterization.
- Awareness of such rare complications is crucial for surgical and interventional teams to ensure patient safety and proper management.
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