PICC tip malposition example
Abstract:
We report a case of primary malposition of a PICC inserted by guidewire replacement in the emergency room. Intraprocedural tip location by intracavitary electrocardiography was not feasible because the patient had atrial fibrillation; intraprocedural tip location by ultrasound (using the so-called “bubble test”) showed that the tip was not in the superior vena cava or in the right atrium. A post-procedural chest X-ray confirmed the malposition but could not precise the location of the tip. A CT scan (scheduled for other purposes) finally visualized the tip in a very unusual location, the left pericardiophrenic vein.
Reference:
Piano A, Carnicelli A, Gilardi E, Bonadia N, Wolde Sellasie K, Pittiruti M, Pennisi MA. Unusual malposition of a peripherally inserted central catheter into the left pericardiophrenic vein: A case report. J Vasc Access. 2021 May 20:11297298211018945. doi: 10.1177/11297298211018945. Epub ahead of print. PMID: 34011220.