“Inadvertent arterial placement is the principal consideration that should be excluded when a left-sided CVC fails to cross the midline as anticipated. Occasional anatomic variants may exist that can be more readily delineated with the use of cross-sectional imaging if needed.”Reference:
Watson J, Davis JE. Elderly man with abnormal chest radiograph after central venous catheter insertion. J Am Coll Emerg Physicians Open. 2022 Sep 30;3(5):e12826. doi: 10.1002/emp2.12826. PMID: 36203537; PMCID: PMC9523549.