Aortic dissection: unusual and rare complication during subclavian vein catheterization in a hemodialysis patient

We present a 56-year-old female with end stage renal disease [ESRD]. As the patient had no vascular access for hemodialysis, the catheter was inserted in the right subclavian vein without an imaging guide. The woman experienced sudden chest pain and hypotension. Imaging showed a malposition of the catheter in the subclavian artery instead of the subclavian vein with dissection of the thoracic and abdominal aorta. This is a rare complication of subclavian vein catheterization for hemodialysis. We discuss this patient because she is the first in the international bibliography. This case report shows that for patients with poor venous access, catheter placement under angiographic control may be helpful