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

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.

Inadvertent Catheterization of the Ascending Lumbar Vein

2009 ◽  
Vol 28 (3) ◽  
pp. 179-183 ◽  
Author(s):  
Carol Trotter
Keyword(s):  
Contrast Material ◽  
Spinal Column ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Contrast Injection ◽  
Venous Plexus ◽  
Central Venous ◽  
X Ray ◽  
Lumbar Vein ◽  
Ascending Lumbar Vein

A NUMBER OF SERIOUS COMPLICATIONS can arise from malpositioned central venous catheters (CVCs), including cardiac tamponade and perforation, pleural effusions, and infusion into the vertebral venous system anywhere along the spinal column. Figure 1 is an x-ray of a premature infant taken after insertion of a 2.0 Silastic peripherally inserted central catheter (PICC), demonstrating the catheter entering the left ascending lumbar vein (ALV). Routine contrast injection of 0.3 mL of iothalamate meglumine 60 percent (Conray, Covidien Imaging Solutions, Hazelwood, Missouri) at the time of the PICC-placement film demonstrated that the contrast material extended into the vertebral venous plexus. The catheter was immediately withdrawn before intravenous fluid was administered, and the infant experienced no complications.

Contributing Factors for a Late Spontaneous Peripherally Inserted Central Catheter Migration: A Case Report and Review of Literature

2015 ◽  
Vol 16 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Paolo Beccaria ◽  
Simona Silvetti ◽  
Milena Mucci ◽  
Ivana Battini ◽  
Paola Brambilla ◽  
...  
Keyword(s):  
Case Report ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Review Of Literature ◽  
Contributing Factors ◽  
Catheter Migration

Real-time ultrasound-guided placement of peripherally inserted central venous catheter without fluoroscopy

2018 ◽  
Vol 19 (6) ◽  
pp. 609-614 ◽  
Author(s):  
Soshi Nakamuta ◽  
Toshihiro Nishizawa ◽  
Shiori Matsuhashi ◽  
Arata Shimizu ◽  
Toshio Uraoka ◽  
...  
Keyword(s):  
Success Rate ◽  
Detection Rate ◽  
Ultrasound Guidance ◽  
Catheter Placement ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Ultrasound Guided ◽  
Peripherally Inserted Central Catheters ◽  
X Ray ◽  
Central Catheters

Background and aim: Malposition of peripherally inserted central catheters placed at the bedside is a well-recognized phenomenon. We report the success rate of the placement of peripherally inserted central catheters with ultrasound guidance for tip positioning and describe the knacks and pitfalls. Materials and methods: We retrospectively reviewed the medical case charts of 954 patients who received peripherally inserted central catheter procedure. Patient clinical data included success rate of puncture, detection rate of tip malposition with ultrasonography, adjustment rate after X-ray, and success rate of peripherally inserted central catheter placement. Results: The success rate of puncture was 100% (954/954). Detection rate of tip malposition with ultrasonography was 82.1% (78/95). The success rate of ultrasound-guided tip navigation was 98.2% (937/954). The success rate of ultrasound-guided tip location was 98.0% (935/954). Adjustment rate after X-ray was 1.79% (17/952). The final success rate of peripherally inserted central catheter placement was 99.8% (952/954). Conclusion: Ultrasound guidance for puncturing and tip positioning is a promising option for the placement of peripherally inserted central catheters. Ultrasound guidance could dispense with radiation exposure and the transfer of patients to the X-ray department.

The Use of CT Imaging Technology in Peripherally Inserted Central Catheter

2021 ◽  
Vol 11 (1) ◽  
pp. 114-119
Author(s):  
Ying Wu ◽  
Guohua Huang ◽  
Qiufeng Li ◽  
Jinai He
Keyword(s):  
Superior Vena Cava ◽  
Right Atrium ◽  
Superior Vena ◽  
Vena Cava ◽  
Ct Imaging ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
Imaging Technology ◽  
X Ray ◽  
The Right

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.

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

2018 ◽  
Vol 19 ◽  
pp. 491-493
Author(s):  
Yuri Imakiire ◽  
Tomoaki Yanaru ◽  
Hitomi Kumano ◽  
Erisa Nakamori ◽  
Ken Yamaura
Keyword(s):  
Case Report ◽  
Peripherally Inserted Central Catheter ◽  
Central Catheter ◽  
The Right
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