Figure 19.

A 59-year-old male status post bedside central line placement. The procedure was complicated by pneumothorax and inadvertent arterial placement. (A) Chest radiograph demonstrating a right sided pneumothorax (white arrow), and a central line which crosses midline and terminates near the level of the left main bronchus, consistent with inadvertent arterial access (black arrows). (B-D) Axial contrast enhanced CT, maximum intensity projection images, and 3D reconstruction of the aorta and great vessels all demonstrating the catheter entering the right brachiocephalic artery and coursing into the descending aorta. (E) This required treatment with endovascular stent graft placement over the arterial puncture site in the right brachiocephalic artery (black arrow).