Venous Dissection Visible on Contrast-Enhanced Computed Tomography: A Complication Associated With Replacement of a Central Venous Catheter

TL;DR

A rare case of venous dissection during central venous catheter replacement was diagnosed using contrast-enhanced CT, showing it can help avoid unnecessary treatments.

Contribution

Demonstrates the utility of contrast-enhanced CT in diagnosing venous dissection without requiring further intervention.

Findings

Venous dissection was diagnosed using contrast-enhanced CT during catheter replacement.

Follow-up imaging showed partial resolution of the dissection without additional treatment.

Contrast-enhanced CT can help avoid unnecessary interventions when the false lumen is patent.

Abstract

Venous dissection is an uncommon complication that can occur following venous puncture, catheter insertion, or manipulation. We report a case of venous dissection that occurred during the replacement of a central venous catheter (CVC). A 77-year-old woman underwent replacement of a cuffed catheter via the left internal jugular vein. Advancement of the guidewire and dilator resulted in a venous dissection extending from the left internal jugular vein to the brachiocephalic vein, which was diagnosed upon contrast-enhanced computed tomography (CT). No further treatment was necessary, and a follow-up contrast-enhanced CT three weeks later showed partial resolution of the dissection. This case represents a rare instance in which venous dissection was successfully diagnosed using contrast-enhanced CT. Most reported cases of venous dissection have not required additional treatment. When the false lumen is patent, contrast-enhanced CT can be useful for the diagnosis of venous dissection and may help avoid unnecessary interventions.

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