Malposition of central venous catheter in left superior intercostal vein in a patient with superior vena cava syndrome

Dopływy lewej żyły ramienno-głowowej, problem kaniulacji żył centralnych/centralnego cewnikowania żylnego i potencjalny wszczepialnych urządzeń elektronicznych serca

“…Abnormal dilation of the left SCIV may be due to congenital vascular anomalies or an occlusion in the superior vena cava (SVC), inferior vena cava (IVC), or azygos veins [13,14]. The appearance of a previously absent aortic nipple in chest radiography (AP view), may indicate the development of venous thrombosis in the BCV, SVC, or IVC [5,15].…”

Accidental Cannulation of Left Superior Intercostal Vein: A Rare Instance of Central Venous Catheter Malpositioning

“…Dynamic radiograph while injecting small volume contrast into central venous catheter port can help in delineating venous anatomy and confirm tip location. Padovan et al [6] and Vahid et al [7] used computed tomography (CT) to confirm the malposition of the catheter into left superior intercostals vein. Computed tomography (CT) may be of use to confirm the tip location, however, routine use cannot be recommended for confirming catheter tip due to concerns of high radiation exposure.…”

Bedside Procedure: Retained Central Venous Catheter

“…Catheter malposition into the innominate, left internal mammary, azygous, hemiazygos, lateral thoracic, inferior thyroid, intercostal, and thymic veins have occurred [46,47]. Incorrect position can result in inaccurate hemodynamic monitoring, thrombosis, and arrhythmias [6,[45][46][47].…”

“…If resistance is encountered, it may be from extraluminal placement, kinking, entrapment, or intraluminal stenosis [8,25,47,58,59]. When this occurs, remove the needle and guide wire en bloc (together), inspect immediately to verify complete removal, obtain new equipment and reinitiate procedure [12,15,16].…”