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Silicone PICC fracture and embolization of catheter fragments

"This case highlights the fact that silicon PICCs are fragile and have a high risk of spontaneous dislodgement and should be replaced by better alternative polyurethane PICCs" Joga et al (2021).

Abstract:

Peripherally inserted central catheters (PICC) are widely used in oncology for administration of chemotherapy. However, sometimes there may be complications associated with them such as infections, thrombosis and rarely fracture of catheter and embolization of the catheter fragments. Here we report a case of 59-year old gentleman with locally advanced carcinoma of head of pancreas, who had spontaneous fracture of a silicon based PICC and later migration of the catheter fragment through the heart and further into the right pulmonary arterial system. The embolized catheter fragment was retrieved through a vascular snare from the right femoral venous route. This case highlights the fact that silicon PICCs are fragile and have a high risk of spontaneous dislodgement and should be replaced by better alternative polyurethane PICCs.

Reference:

Joga S, Bansal A, Talwar V, Bothra SJ, Dash P, Goel V, Koyyala VPB. Spontaneous pulmonary arterial embolization: A rare complication of the silicon-based peripherally inserted central venous catheter (PICC). J Vasc Access. 2021 Feb 18:1129729821993963. doi: 10.1177/1129729821993963. Epub ahead of print. PMID: 33596729.