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Venous Catheterization with Aortic Arch
Question:
What catheter placements would be captured in this diagnostic case without intervention?
Access obtained with a 4 Fr in the RFA and a 6 Fr in the RFV. This was followed by diagnostic angiography in the aortic arch ruling out vascular injury. Then, the 4 Fr NTAG catheter was advanced from the venous sheath into the left innominate vein. To avoid extravasating the catheter hand injections were performed as it was advanced in the left innominate vein, left subclavian and axillary vein. Hand injections in the left axillary vein and LIJ ruled out venous injury.
1. Power injection with catheter in the descending aorta at the origin of the left subclavian artery shows no vascular injury of the left subclavian or axillary arteries.
2. Hand injection in the left axillary vein shows no vascular injury
3. Hand injection of the left IJ shows no vascular injury
4. Power injection of the left innominate vein demonstrates integrity of the vein
5. Hand injection in the left axillary vein was repeated showing no extravasation of the contrast
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