"We reported a pediatric case requiring prolonged antibiotic therapy for sacral osteomyelitis, in which PICC placement was initially unsuccessful because of resistance encountered during catheter advancement. Venography revealed significant venous stenosis, which allowed successful catheter placement after the guidewire was redirected into a patent vessel" Tokuda et al (2025).
Peripherally inserted central catheter placement in pediatric patients

Abstract:

Peripherally inserted central catheters (PICCs) are commonly used in pediatric patients for long-term IV access because of their ease of insertion and lower risk of complications such as pneumothorax or hemothorax. However, difficulties may arise when advancing the catheter due to venous stenosis or occlusion. We reported a pediatric case requiring prolonged antibiotic therapy for sacral osteomyelitis, in which PICC placement was initially unsuccessful because of resistance encountered during catheter advancement. Venography revealed significant venous stenosis, which allowed successful catheter placement after the guidewire was redirected into a patent vessel. This case highlighted the utility of venographic assistance in instances of PICC insertion failure.

Reference:

Tokuda Y, Nakao H, Morooka S, Kubota M. Venographic Assistance in Peripherally Inserted Central Catheter Placement in a Pediatric Patient: A Case Report. Cureus. 2025 Aug 21;17(8):e90697. doi: 10.7759/cureus.90697. PMID: 40984925; PMCID: PMC12450237.