Ultrasound guidance is useful for venipuncture and placement of central venous access catheters; however, anatomical variants may complicate catheter insertion. A 52-yr-old female patient was admitted to the intensive care unit with acute respiratory distress due to bilateral pneumonia. Her respiratory status worsened rapidly and she required mechanical ventilation. For cardiovascular monitoring, an ultrasound-guided cannulation of her left subclavian vein was performed uneventfully using an Acuson CV70~(TM) cardiovascular ultrasound system (Siemens~R, Erlangen, Germany), and a central venous catheter (CVC) was inserted.
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