Malposition of hemodialysis catheter in left superior intercostal vein

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Nephrology

Background:

• Hemodialysis catheter malposition can lead to suboptimal treatment and complications.
• Prompt and accurate diagnosis of catheter placement is essential for patient safety and effective dialysis.
• The internal jugular vein is a common site for central venous catheter insertion.

Observation:

• A case of a left-sided internal jugular hemodialysis catheter presenting with unusually straight descent is described.
• Standard imaging protocols were employed to assess the catheter's position.
• The catheter tip was visualized in an unexpected location.

Findings:

• The hemodialysis catheter had descended into the superior intercostal vein, a rare anatomical variation.
• This unusual course was confirmed through diagnostic imaging.
• The catheter's position, while atypical, was deemed functional after thorough evaluation.

Implications:

• This case highlights the importance of considering anatomical variations in interpreting catheter placement.
• Clinicians should be aware of potential unusual pathways for internal jugular catheters to avoid misdiagnosis.
• A systematic approach to evaluating catheter malposition prevents unnecessary interventions and patient anxiety.