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. 2016 Jan 20;129(2):227-34.
doi: 10.4103/0366-6999.173525.

Malposition of Central Venous Catheter: Presentation and Management

Lin Wang, Zhang-Suo Liu  1 , Chang-An Wang
Affiliations

Malposition of Central Venous Catheter: Presentation and Management

Lin Wang et al. Chin Med J (Engl). .
No abstract available

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Figures

Figure 1
Figure 1
(a) The trunk of the superior vena cava system. It shows that left internal jugular vein negotiates two 90° turns. (b) Tributaries of the superior vena cava system. It shows that the superior vena cava drains venous blood from the upper half of the body in which there would be variable and complicated considerably.
Figure 2
Figure 2
A anatomic illustration of the jugular lymphatic trunk. It indicates that the thoracic duct is medial close to the internal jugular vein in front of the internal jugular vein.
Figure 3
Figure 3
Catheter misplacement to intra-artery. (a) Chest film shows the tip of the catheter passing close to the aortic arch (arrow). (b) Further imaging indicates the tip of the catheter lying in the position of the arterial system (arrow).
Figure 4
Figure 4
Chest film shows that the guide wire enters to azygos veins system through the left internal jugular vein during catheterization (arrow).
Figure 5
Figure 5
Catheter misplacement to the persistent left-sided SVC.[32] (a) The chest X-ray demonstrates that dialysis catheter passes down the left side of the mediastinum with pleural effusion and subcutaneous emphysema over the left clavicle (arrow). (b) Computed tomography chest demonstrates the catheter in the persistent left-sided SVC, pericardial and pleural effusion from coronal view (arrow). (c) The arrow indicates the catheter in the persistent left-sided SVC from conventional view. SVC: Superior vena cava.
Figure 6
Figure 6
Catheter misplacement to the right internal mammary vein.[33] (a) Chest X-ray: Anterior-posterior demonstrating what appears to be good position of catheter in the superior vena cava. (b) Computed tomography (axial image): Catheter malposition to the right of the sternum.
Figure 7
Figure 7
Catheter misplacement to the vertebral vein.[37] Chest X-ray shows that the central venous catheter passes the transverse processes of the 6th and the 7th cervical vertebrae (arrow).
Figure 8
Figure 8
The misplacement of a left internal jugular vein catheter. (a) The chest film shows both of lumens’ inadvertent insertion into the right internal jugular vein (arrow). (b) The chest film shows one of lumen dwelling into the right internal jugular vein (arrow).
Figure 9
Figure 9
Catheter misplacement to the subclavian vein.[39] Chest radiograph shows that the catheter is inserted via the right internal jugular vein and loops in the subclavian vein.
Figure 10
Figure 10
Catheter misplacement to the extradural space.[41] Cervical computed tomography scans demonstrate that the central venous catheter has penetrated the posterior aspect of the internal jugular vein. (a) Chest radiograph reveals that the tip of the central venous line (arrows) runs inside the normal route of the internal jugular vein and appears to overlap with the cervical spine (arrows). (b) The cervical computed tomography scan demonstrates that the catheter travels posterior to the carotid artery (arrows). (c) The cervical computed tomography scan shows that the catheter penetrates the prevertebral fascia (arrow). (d) The image indicates that the catheter enters the intervertebral foramen (arrow).
Figure 11
Figure 11
Catheter misplacement to the pericardium.[6] Chest radiograph reveals that the tip of the catheter is seen to lie within the right atrium (arrow).
Figure 12
Figure 12
Catheter misplacement to the pleural space.[6] (a) The left-sided dialysis catheter has perforated through the right wall of SVC, and the tip has entered the right pleural space (arrow). (b) The left-sided dialysis catheter has perforated through the right wall of SVC and kink in the right pleural space (arrow). CVC: Central venous catheter; SVC: Superior vena cava.
Figure 13
Figure 13
Catheter misplacement to the mediastinum.[6] The computed tomography image shows the mediastinum grows for the huge hematoma. SVC: Superior vena cava.
Figure 14
Figure 14
Catheter misplacement to the thoracic duct.[44] (a) Scout view of the chest computed tomography shows the guidewire (arrows) takes a straight craniocaudal course projecting on the vertebral column reaching caudal to the diaphragm. (b) Computed tomography cross-sectional image at the level of the middle mediastinum. The guidewire (arrow) can be seen in a prevertebral position adjacent to the descending aorta and posterior to the esophagus.
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