Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.190097
Jornal Vascular Brasileiro
Case Report

Inadvertent insertion of a venous catheter into the internal thoracic vein: a word of caution

Implante inadvertido de cateter venoso central na veia torácica interna: um alerta

Flavia Ramos Tristão; Ricardo César Rocha Moreira; Carlos Eduardo Del Valle; Giana Caroline Strack Neves

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Abstract

Abstract: Central venous catheters are widely used in clinical practice and are linked to many types of complications, including incorrect positioning at the time the catheter is fitted. Here, the authors describe a case in which a fully implantable catheter was inadvertently positioned in the right internal thoracic vein. The complication was identified when the nursing team attempted to use the catheter. The right internal thoracic vein is within the radiographic projection of the right brachiocephalic vein and the superior vena cava, simulating correct catheter placement on an anteroposterior radiograph. In cases of central catheter malfunction during the immediate postoperative period, work-up should include oblique and lateral views, to rule out the complication described here without a need for computed tomography.

Keywords

catheters, adjuvant chemotherapy, vascular surgical procedures

Resumo

Resumo: Os cateteres venosos centrais são amplamente usados na prática clínica e estão relacionados a vários tipos de complicações, entre elas o mau posicionamento no momento do implante do cateter. Os autores relatam o caso de um cateter totalmente implantável que foi inadvertidamente posicionado na veia torácica interna direita, sendo a complicação reconhecida após tentativa do uso do cateter na enfermaria. A veia torácica interna direita fica na projeção da veia inominada direita e da veia cava superior, simulando um bom posicionamento do cateter na radioscopia em projeção anteroposterior. Em caso de mau funcionamento de um cateter central no pós-operatório imediato, a conduta deve incluir imagens oblíquas ou de perfil, para excluir a complicação relatada neste trabalho sem necessidade de tomografia computadorizada.
 

Palavras-chave

cateteres, quimioterapia adjuvante, procedimentos cirúrgicos vasculares

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