Introduction: Central venous catheters are an integral part of the management of the acutely unwell patient but their use is not without risks. Report: An 11F double lumen central venous catheter was inadvertently placed into the verte- bral artery when the landmark technique was used to obtain an internal jugular vein puncture. The patient required a sternotomy for adequate exposure, and the vertebral artery was ligated. Discussion: This case demonstrates a rare complication of large bore central venous catheter- isation requiring major open surgical repair and is the first reported case of an 11F catheter placed in the vertebral artery requiring surgical ligation.
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