The misplaced thoracic venous catheter: detailed anatomical consideration

When interpreting routine radiographs following thoracic venous catheterization, a thorough knowledge of normal venous anatomy is necessary to prevent potential complications of central venous catheter misplacement. In the following report, we review the thoracic venous anatomy and show examples of azygous, superior intercostal, internal mammary, inferior thyroid, pericardiophrenic, and left superior vena cava catheterizations, as well as the more common venous catheter misplacements. The use of both frontal and lateral radiographs for catheter localization is discussed in detail.