[On the perforation of central venous catheters; radiological aspects of diagnosis and prevention (author's transl)].

Three cases of cardiac tamponade resulting from perforation of central venous catheters are presented. Purpose of the case reports and of the brief literature review is to derive criterions for X-ray examination of the catheter position since only routine roentgenographic control can prevent the occurrence of catheterization -- induced complications significantly. The catheter tip should not exceed the right sternoclavicular border by more than two centimeters. Roentgenograms of catheters inserted via the brachial venous route have to be obtained with the arm abducted 90 degrees. On adequately exposed Roentgen films the vertebral column should be clearly discernible within the cardiac shadow. Injection of radiopaque dye through the catheter helps to locate its tip and, in addition, confirms the diagnosis of catheter perforation and concomitant pericardial tamponade.