Malposition of Peripherally Inserted Central Catheter Into the Right Inferior Thyroid Vein: A Case Report

Objective: The objective is to explore the application of computed X-ray tomography (CT) imaging technology in peripherally inserted central catheter (PICC), and to propose a more effective method for PICC catheterization. Method: In this study, 69 subjects are divided into the observation group (X-ray and CT) and the control group (X-ray). The guiding effect of CT images on PICC tube placement in complex cases is compared. In this study, CT localization of the superior vena cava–caval-atrial junction (CAJ) is used as the gold standard. The position relationship of carina-CAJ and carina-PICC catheter tip is measured and analyzed by CT image and chest radiography (CXR) image, providing scientific basis for PICC tip imaging. Results: After this study, the tip of the catheter should be 1/3 of the middle and lower part of the superior vena cava, about 3 cm above the junction of the right atrium and the superior vena cava, and in the upper part of the diaphragm of the inferior vena cava, so that it cannot enter the right ventricle or the right atrium. The best position of the tip of the catheter is near the junction of the superior vena cava and the right atrium. The average vertical distance between the tracheal carina and CAJ is 4.79 cm. Conclusion: CT and X-ray examination can effectively determine the location of the tip of PICC catheter in cancer chemotherapy patients, but the clarity of X-ray examination is missing. It is suggested to adopt CT examination, and further adopt and promote it.

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Dislodgement of a Power-Injectable Peripherally Inserted Central Catheter After Power Injection: A Case Report

Journal of the Association for Vascular Access ◽

10.1016/j.java.2012.12.002 ◽

2013 ◽

Vol 18 (1) ◽

pp. 27-29 ◽

Cited By ~ 2

Author(s):

Boon Keat Lim ◽

Babu Suresh Balasubramaniam

Keyword(s):

Computed Tomography ◽

Original Position ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Intravenous Contrast ◽

Intravenous Contrast Medium ◽

Power Injection ◽

Scout View ◽

The Right ◽

Enhanced Computed Tomography

A 63-year-old Malay woman had a 6-French dual-lumen power-injectable peripherally inserted central catheter (PICC) inserted and subsequently underwent a contrast-enhanced computed tomography scan with intravenous contrast medium administered via the PICC. After the scan, the tip of the PICC was noted to have displaced from its original position and lodged in 1 of the small branches of the right subclavian vein. This phenomenon was then demonstrated in real time under fluoroscopy during the process of repositioning the PICC tip. Although power-injectable PICCs are designed for use with power injectors, tip displacement can and does happen. A computed tomography scout view of the chest may be necessary after each use of power injectors to confirm that the PICC tip remains in a satisfactory position.

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An Unusual Peripherally Inserted Central Catheter (PICC) Fractured <i>in Vivo</i> with Embolization Happened in a Child: A Case Report

Case Reports in Clinical Medicine ◽

10.4236/crcm.2015.41003 ◽

2015 ◽

Vol 04 (01) ◽

pp. 10-13 ◽

Cited By ~ 2

Author(s):

Fang Fang ◽

Hongyan Zhang ◽

Wu Yang

Keyword(s):

Case Report ◽

Peripherally Inserted Central Catheter ◽

Central Catheter

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Rescue of a patient with a 50 cm broken PICC tube retracted and wrapped in pulmonary artery: a case report

Frontiers of Nursing ◽

10.2478/fon-2021-0045 ◽

2021 ◽

Vol 8 (4) ◽

pp. 445-450

Author(s):

Sha Yang ◽

Ren-Tao Yu ◽

Hui-Lan Zhang ◽

Xue Jiang ◽

Jian-Ping You

Keyword(s):

Chronic Hepatitis ◽

Case Report ◽

Pulmonary Artery ◽

First Aid ◽

Decompensated Cirrhosis ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Foreign Matter ◽

X Ray ◽

Patient Concerns

Abstract Objective With the increasing use of a peripherally inserted central catheter (PICC) in clinical application, the breaking of the PICC is increasing as well, which would turn into the emboli and drift to the heart and pulmonary artery, causing severe consequences. However, few cases have been reported on the rescue of patients with a broken PICC. Patient concerns A 33-year-old man, diagnosed with chronic hepatitis B-related decompensated cirrhosis and cryptococcal meningitis, was treated with amphotericin B combined with flucytosine and fluconazole by means of PICC catheterization. The patient was discharged with a catheter; when he returned for re-examination, a 50cm length of PICC broke and slipped into the vein after his sudden dysphoria. First aid was immediately administered, and then the intervention therapy to extricate the tube, including pulmonary artery angiography and intravascular removal of foreign matter, was performed based on the consensus of the in-hospital vein treatment group. At last, the broken PICC fragment was successfully taken out of the vessel. Re-examination after surgery showed that he recovered well. Conclusions Once the catheter is broken, the X-ray examination should be performed at the first instance and re-examined frequently. Moreover, the involvement of a multidisciplinary team should be formed to decide the appropriate method of treatment to ensure a successful rescue.

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Trimethoprim-Sulfamethoxazole–Induced Stevens-Johnson Syndrome

Journal of the American Podiatric Medical Association ◽

10.7547/1000299 ◽

2010 ◽

Vol 100 (4) ◽

pp. 299-303 ◽

Cited By ~ 7

Author(s):

Michael R. Langlois ◽

Francis Derk ◽

Ronald Belczyk ◽

Thomas Zgonis

Keyword(s):

Adverse Reaction ◽

Case Report ◽

Toxic Epidermal Necrolysis ◽

Stevens Johnson Syndrome ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Unique Case ◽

Diabetic Foot Infections ◽

Johnson Syndrome ◽

Antibiotic Drug

Stevens-Johnson syndrome and toxic epidermal necrolysis are rare; however, when they occur, they usually present with severe reactions in response to medications and other stimuli. These reactions are characterized by mucocutaneous lesions, which ultimately lead to epidermal death and sloughing. We present a unique case report of Stevens-Johnson syndrome and associated toxic epidermal necrolysis in a 61-year-old man after treatment for a peripherally inserted central catheter infection with trimethoprim-sulfamethoxazole. This case report reviews a rare adverse reaction to a commonly prescribed antibiotic drug used in podiatric medical practice for the management of diabetic foot infections. (J Am Podiatr Med Assoc 100(4): 299–303, 2010)

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