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

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.