A Case of Mediastinal Migration of a Catheter Following Left Internal Jugular Vein Catheterization

Abstract

Misplacement of central venous catheters（CVCs）can readily occur with central venous catheterization via the left internal jugular vein（IJV）. We report a case of mediastinal migration of a catheter following left IJV catheterization. The left IJV was cannulated, and the catheter tip was placed in the innominate vein. The patient developed dyspnea on day 5 after CVC insertion, and chest computed tomography revealed CVC migration from the innominate vein into the mediastinum. The patient was transferred to the intensive care unit, and we used a contrast agent under fluoroscopic guidance to confirm a connection with the thoracic cavity or pericardium, followed by CVC removal. Based on a review of images obtained during the course of the procedure, we concluded that the CVC tip had migrated into the left pericardiophrenic vein, perforated the vein, and reached the mediastinum. Clinicians should be mindful of late mechanical complications include catheter migration and carefully monitor the patient’s condition and review images after CVC insertion.