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PICC tip perforated wall of superior vena cava

"Contrast computed tomography revealed that the tip of the catheter had perforated the vessel wall of the superior vena cava and had migrated into the mediastinal space" Sakaue et al (2021).

"Contrast computed tomography revealed that the tip of the catheter had perforated the vessel wall of the superior vena cava and had migrated into the mediastinal space" Sakaue et al (2021).

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Abstract:

A 90s woman was diagnosed as having cT4aN2M0, cStage ⅢA, advanced gastric cancer. As she was severely malnourished owing to pyloric stenosis, a peripherally inserted central catheter (PICC)was placed in her left arm, and total parenteral nutrition(TPN)was initiated. She complained of dyspnea, and radiography revealed right pleural effusion on day 4 of TPN. Contrast computed tomography revealed that the tip of the catheter had perforated the vessel wall of the superior vena cava and had migrated into the mediastinal space. After thoracocentesis, the catheter was removed under fluoroscopic guidance after hemostasis was achieved. Thus, the possibility of catheter deviation should be considered in case of dyspnea and pleural effusion during TPN.

Reference:

Sakaue M, Takeno A, Kawai K, Sakamoto T, Murakami K, Katsura Y, Ohmura Y, Kagawa Y, Masuzawa T, Hata T, Takeda Y, Murata K. [Deviation of Peripherally Inserted Central Catheter(PICC)during Total Parenteral Nutrition(TPN)for a Gastric Cancer Patient-A Case of Report]. Gan To Kagaku Ryoho. 2021 Feb;48(2):266-268. Japanese. PMID: 33597377.

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