Time to abandon chest X-rays in favor of intracavitary ECG or echocardiography for central venous access tip location: A case of a malpositioned CICC into the internal mammary vein

Filippo Pelagatti; Fulvio Pinelli

doi:10.1177/11297298221074751

Time to abandon chest X-rays in favor of intracavitary ECG or echocardiography for central venous access tip location: A case of a malpositioned CICC into the internal mammary vein

J Vasc Access. 2023 Nov;24(6):1513-1515. doi: 10.1177/11297298221074751. Epub 2022 Mar 1.

Authors

Filippo Pelagatti¹, Fulvio Pinelli²

Affiliations

¹ School of Human Health Science, University of Florence, Florence, Tuscany, Italy.
² Anesthesia and Intensive Care, University Hospital Careggi, Florence, Tuscany, Italy.

PMID: 35229679
DOI: 10.1177/11297298221074751

Abstract

Central vascular access devices (CVADs) correct tip location is of paramount importance to avoid malposition related complications. Despite recent guidelines recommend avoiding postprocedure radiograph in favor of alternative tip location technology, chest X-rays are still widely used in clinical practice as a CVADs tip location method. We present a clinical case of a central inserted central catheter (CICC) malposition in the right internal mammary vein, erroneously interpreted by chest X-rays as correctly placed, in a critically ill patient.

Keywords: Centrally inserted central catheter; catheter related complications; chest X-rays; internal mammary vein; intracavitary electrocardiography; tip location.

Publication types

Case Reports

MeSH terms

Catheterization, Central Venous*
Central Venous Catheters*
Echocardiography
Electrocardiography / methods
Humans
X-Rays