key: cord-0770542-lhmb94au
authors: Nakayama, Ryuichi; Bunya, Naofumi; Yama, Naoya; Nonaka, Tatsuki
title: Self‐correction of a migrated power‐injectable peripherally inserted central catheter following contrast‐enhanced computed tomography
date: 2022-02-01
journal: Clin Case Rep
DOI: 10.1002/ccr3.5385
sha: 56431de1646baea1b52c95d9a3c8621f2534a664
doc_id: 770542
cord_uid: lhmb94au

The use of power‐injectable peripherally inserted central catheter (PIPICC) is a common practice, but displacement of these lines following injection of contrast media has been reported in 15.4% of cases. This report presents imaging evidence of displacement and self‐correction of a PIPICC line following contrast‐enhanced computed tomography.

A 66-year-old man receiving lung-protective mechanical ventilation for acute respiratory distress syndrome from COVID-19 was introduced to a power-injectable peripherally inserted central catheter (PIPICC) on the 27th day of ICU for multiple drug infusion (propofol, fentanyl, midazolam, rocuronium). The line was an open-ended, triple-lumen 5-French PIPICC (Bard Access Systems, Inc.). Chest radiography prior to computed tomography (CT) showed the catheter was in the normal position ( Figure 1A ). Contrast-enhanced CT for deep vein thrombosis of the internal jugular vein demonstrated that the catheter tip was being moved (Video S1) and looped in the right internal jugular vein ( Figure 1B ). One hour after CT, a fluoroscopy room check showed that the catheter tip had spontaneously returned to proper position without intervention ( Figure 1C ).

Although PIPICC use is common, displacement of PIPICC following contrast media injection occurs in 15.4% of cases 1 and can be associated with catheter-related thrombosis, 2 suggesting that the wandering catheter needs to be reinserted or repositioned. However, this report shows self-correction of a migrated PIPICC 1 h after contrast media injection. Abnormalities in the PIPICC position after contrast-enhanced CT may rectify spontaneously, but physicians should be aware that intervention will be required if the PICC tip does not self-correct.

Additional supporting information may be found in the online version of the article at the publisher's website. 

Power injectable peripherally inserted central venous catheter lines frequently flip after power injection of contrast

Incidence, risk factors and clinical outcomes of peripherally inserted central catheter spontaneous dislodgment in oncology patients: a prospective cohort study

We would like to thank Editage (www.edita ge.com) for English language editing.

The authors declare no conflicts of interest.

All authors contributed significantly. Ryuichi Nakayama wrote and edited the manuscript. Ryuichi Nakayama, Naofumi Bunya, and Tatsuki Nonaka treated the patient. Naofumi Bunya and Naoya Yama coordinated, co-wrote, and co-edited the paper. All authors accessed the data.

Appropriate written informed consent was obtained from the patient for publication of this case report and accompanying images.

Data available on request from the authors.

Ryuichi Nakayama https://orcid. org/0000-0002-3272-7680