A peripherally inserted central catheter misplacement into lateral thoracic vein: A case report

Area of Science:

• Vascular access procedures
• Interventional radiology
• Medical device complications

Background:

• Central venous catheter (CVC) tip position is critical for efficacy and safety.
• Catheter misplacement is a rare but significant complication.
• This report details an unusual case of peripherally inserted central catheter (PICC) misplacement.

Observation:

• A peripherally inserted central catheter (PICC) was placed via the left basilic vein in a cancer patient.
• Post-procedure X-ray revealed the catheter tip malpositioned in the lateral thoracic vein, not the superior vena cava.
• The catheter was successfully repositioned.

Findings:

• Peripherally inserted central catheters (PICCs) can misdirect into the lateral thoracic vein due to its anatomical course.
• Dilatation of the lateral thoracic vein, potentially due to pathological conditions, increases misplacement risk.
• This complication highlights the importance of precise catheter navigation.

Implications:

• Reinforces the need for meticulous pre-procedural assessment, including patient history.
• Emphasizes the utility of real-time imaging guidance during catheter insertion.
• Underscores the necessity of routine radiographic confirmation of catheter tip location to prevent serious complications.