Indian Journal of Critical Care Case Report

Register      Login

VOLUME 2 , ISSUE 3 ( May-June, 2023 ) > List of Articles


The Central Venous Catheter that Took a Wrong Stroll

Priyadharshini Ramakrishnan, Sasi Mayukha Challa Venkat, Chandrasekhar Ethiraj, Balasubramaniam Palanisamy, Balaji Venkatachalam

Keywords : Central venous catheter, Central venous cannulation, Internal jugular vein

Citation Information : Ramakrishnan P, Venkat SM, Ethiraj C, Palanisamy B, Venkatachalam B. The Central Venous Catheter that Took a Wrong Stroll. 2023; 2 (3):55-58.

DOI: 10.5005/jp-journals-11006-0048

License: CC BY-NC 4.0

Published Online: 26-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Central venous catheter (CVC) insertion is one of the most commonly performed procedures in anesthesia and critical care medicine practice in order to ease the administration of intravenous (IV) medications and hemodialysis as well. CVC misplacement can occur, even in expert hands, despite the widespread use of ultrasound (USG) guidance. Such catheterization sometimes comes with risks of unpremeditated puncture of other vascular structures and pleura or other nearby structures, causing serious life-threatening complications.1 CVC insertion using USG guidance has remarkably reduced the complications associated with anatomical disruptions.2 Nevertheless, the catheter could still get misplaced if it follows an aberrant route even after proper puncture of the desired vessel. In order to highlight the rare complications that could occur with CVC placements, we report a case describing the CVC misplacement into the innominate artery extending into the anterior end of the arch of the aorta and subsequent patient management requiring a sternotomy.

  1. Ruesch S, Walder B, Tramèr MR. Complications of central venous catheters: internal jugular versus subclavian access – a systematic review. Crit Care Med 2002;30(2):454–460. DOI: 10.1097/00003246-200202000-00031
  2. Tan PL, Gibson M. Central venous catheters: the role of radiology. Clin Radiol 2006;61(1):13– 22. DOI: 10.1016/j.crad.2005.07.010
  3. Rangarajan S, Rangarajan S, Hinton LS. An unusual case of a misplaced left internal jugular vein catheter. IJCRI 2013;4(10):567–570. DOI: 10.5348/ijcri-2013-10-381-CR-10
  4. Bhange PH, Bhojraj SS. Misplaced chemotherapy-port catheter following left internal jugular venous cannulation. J Anaesth Crit Care Case Rep 2016;2(1):23–24.
  5. Gibson F, Bodenham A. Misplaced central venous catheters: applied anatomy and practical management. Br J Anaesth 2013;110(3):333–346. DOI: 10.1093/bja/aes497.
  6. Ghafoor H, Fatimi Sh, Ali, M. Unusual malposition of dialysis catheter in the left internal mammary vein–a case report. Middle East J Anaesthesiol 2011;21(1):139–141.
  7. Bowdle A. Vascular complications of central venous catheter placement: evidence-based methods for prevention and treatment. J Cardiothorac Vasc Anesth 2014;28(2):358–368. DOI: 10.1053/j.jvca.2013.02.027
  8. Ali MA, Raikar K, Kishore A. A case of misplaced permacath dialysis catheter. Indian J Crit Care Med 2015;19(8):490–492. DOI: 10.4103/0972-5229.162473
  9. Biswas S, Sidani M, Abrol S. Emergent median sternotomy for mediastinal hematoma: a rare complication following internal jugular vein catheterization for chemoport insertion—a case report and review of relevant literature. Case Rep Anesthesiol 2014;2014:1–5. DOI: 10.1155/2014/190172
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.