A rare central venous catheter malposition: a case report

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Critical Care Medicine

Background:

• Central venous catheterization is a common procedure in critical care.
• Proper catheter placement is crucial to prevent serious complications.
• Malposition can lead to significant morbidity and mortality.

Observation:

• This case report details an unusual central venous catheter malposition.
• The catheter was unexpectedly directed into the left internal mammary vein.
• This occurred during an attempt at left internal jugular vein cannulation.

Findings:

• The left-sided bevel of the insertion needle may influence guidewire and catheter trajectory.
• Accidental navigation into the left internal mammary vein occurred instead of the intended subclavian vein.
• This highlights a potential anatomical pitfall during left-sided internal jugular vein access.

Implications:

• Awareness of this potential malposition is important for clinicians performing central venous catheterizations.
• Careful attention to needle bevel orientation and guidewire manipulation is necessary.
• Understanding such rare complications can improve patient safety and procedural outcomes.