There was an intersection near University Place, WA with offset through movements. As you can see in
this street view image, drivers would often continue straight ahead in the intersection, only to find themselves driving into the oncoming left turn lane. I don't know if there were any head on collisions, but it was an awkward intersection until finally being fixed recently. Oddly enough, it was like this for a long time.
So I guess the moral of the story is that you
can have through lanes pointing in odd directions, but do expect some odd behavior!

There's also
this intersection near me (a freeway off-ramp) which has three approach lanes: left only, straight and right, and right only. Because it's an off-ramp 99% of vehicles turn left or right, but when someone accidentally exits but needs to re-enter, they have to occupy one of the right turn lanes. Because right on red arrows are allowed here in WA, this double right turn has a near-constant flow most of the day. When someone does arrive to go straight, it really screws with traffic. Always a symphony of horns. This is a situation where the through lane and the left turn lane should be the same, as neither can go on red.