Puncture of the Trachea during Catheterization of the Subclavian Vein

To the Editor: Catheterization of the subclavian vein is frequently performed to gain central venous access for a variety of purposes.¹ We were prompted to submit this report because of a recent complication of this procedure. Pneumonia developed in a 66-year-old woman with neutropenia after chemotherapy for diffuse histiocytic lymphoma and led to respiratory failure, requiring endotracheal intubation and ventilator support. Prolonged respiratory insufficiency led to the placement of a tracheostomy tube. Tracheomalacia, with dilatation of the trachea at the level of the tracheostomy-tube cuff, subsequently developed. On the 20th day of ventilator support, we placed a catheter in the….