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

Abstract

Background: Central venous catheter (CVC) placement plays an important role in the management of critically ill patients. Complication rates have been reduced with the use of image guidance for their placement. Sometimes, particularly in emergency situation or due to lack of image guidance accidental malpositioning of these catheters can occur further adding to morbidity of the critically ill patients. Case Report: Herein we report a case of CVC placement into left superior intercostal vein during a left sided internal jugular vein (IJV) CVC placement. Conclusion: High index of suspicion along with thorough knowledge of anatomy is required to early detect malposition of central venous catheter.

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

“…As mentioned in the introduction, the course of central venous catheterization procedures may be complicated by unintentional insertion (or spontaneous displacement) of a CVC into the left SICV or the left IMV [3,8,11,20]. The venography records from CIED implantations analyzed in this study showed two cases of the left IMVs, one of which resulted in an unintentional lead insertion (as described in the text above).…”

“…Unintentional CVC insertion into a wrong vessel, particularly as the catheter is being introduced via the left jugular or left subclavian vein, typically involves the left superior intercostal vein (SICV) or the left internal thoracic (mammary) vein (IMV) [5][6][7][8][9][10].…”