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"The formation of guidewire knots during PICC insertion is an extreme rare complication" Saito et al (2020).

Abstract:

The formation of guidewire knots during PICC insertion is an extreme rare complication. Forced insertion or withdrawal of a knotted guidewire may cause tearing of the veins. Surgical guidewire removal is required due to risk of vascular injury.

Reference:

Saito H, Suda T, Nishida Y. Guidewire knot formation with peripherally inserted central catheter. Clin Case Rep. 2020 Dec 15;9(2):1035-1036. doi: 10.1002/ccr3.3662. PMID: 33598295; PMCID: PMC7869393.