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Peripherally inserted central catheter malposition to a persistent left superior vena cava

"Persistent left superior vena cava is rare and asymptomatic and is usually discovered incidentally during or after insertion of a central venous catheter" Li et al (2020).

Abstract:

Persistent left superior vena cava is rare and asymptomatic and is usually discovered incidentally during or after insertion of a central venous catheter. There is uncertainty as to whether or not the catheter should be removed after its malposition resulting in persistent left superior vena cava. We reported an unusual case of a breast cancer patient with a persistent left superior vena cava detected after a peripherally inserted central catheter insertion. The patient had undergone a modified radical mastectomy and needed to insert a peripherally inserted central catheter for chemotherapy. After the peripherally inserted central catheter insertion, the chest X-ray and computed tomography showed that the catheter was located in the persistent left superior vena cava. After an assessment of the persistent left superior vena cava and the catheter tip position, the peripherally inserted central catheter remained in the persistent left superior vena cava for further therapy. To ensure the integrity of the catheter, special follow-ups and tip position observations were carried out. The peripherally inserted central catheter was safe until the end of chemotherapy with no complications. Although the peripherally inserted central catheter tip was located in persistent left superior vena cava, given that the persistent left superior vena cava coexisted with a right superior vena cava with the similar lumen, the peripherally inserted central catheter could be used normally under strict attention.

Reference:

Li, Q., Liu, Y., Wang, M., Yu, Z. and Gao, Y. (2020) Peripherally inserted central catheter malposition to a persistent left superior vena cava: A successful case to leave the catheter till the end of chemotherapy. The Journal of Vascular Access. July 4th. https://doi.org/10.1177/1129729820938201 (epub ahead of print).