Kumar Upadhyay Amitabh, Prakash Binayendu, Shekhar Shashank, Kumar Abhishek, Prakash Aaditya
Medical Oncology, Tata Main Hospital, Jamshedpur, IND.
Cardiology, Tata Main Hospital, Jamshedpur, IND.
Cureus. 2023 Aug 6;15(8):e43044. doi: 10.7759/cureus.43044. eCollection 2023 Aug.
The peripherally inserted central catheter (PICC) is a non-tunneled central venous catheter placed in the upper limb venous system, mainly in the basilic vein, and the tip terminates in the superior vena cava (SVC). A PICC is a preferred modality of central venous access in oncology, as it is associated with minimal discomfort and can be kept in situ for up to one year. Despite multiple advantages, it is also associated with complications. Fracture and migration are rare but potentially serious complications that can lead to arrhythmias, cardiac perforation, cardiac tamponade, pulmonary embolism, and sepsis. The migrated PICC fragment can be retrieved using percutaneous techniques, which have a high success rate of excess, with minimum complications. In our patient of adenocarcinoma gastroesophageal junction, the fractured and migrated PICC to pulmonary arteries was retrieved using the balloon catheter method. With more and more cancer patients using PICCs for chemotherapy administration, healthcare workers must be aware of the standard and sporadic complications of PICCs. Care of the PICC is crucial, and any lapse may lead to fracture and embolization, which is a potentially life-threatening complication. This case highlights the importance of healthcare persons being aware of the possibility of catheter embolization and methods to prevent and mitigate this phenomenon.
经外周静脉穿刺中心静脉导管(PICC)是一种非隧道式中心静脉导管,置于上肢静脉系统,主要是贵要静脉,导管尖端位于上腔静脉(SVC)。PICC是肿瘤学中中心静脉通路的首选方式,因为它引起的不适最小,且可在原位保留长达一年。尽管有诸多优点,但它也会引发并发症。断裂和移位是罕见但可能严重的并发症,可导致心律失常、心脏穿孔、心包填塞、肺栓塞和败血症。移位的PICC碎片可采用经皮技术取出,成功率高且并发症少。在我们的胃食管交界腺癌患者中,采用球囊导管法取出了断裂并移位至肺动脉的PICC。随着越来越多的癌症患者使用PICC进行化疗给药,医护人员必须了解PICC的常见和偶发并发症。PICC的护理至关重要,任何失误都可能导致断裂和栓塞,这是一种潜在的危及生命的并发症。本病例凸显了医护人员意识到导管栓塞可能性以及预防和减轻这种现象方法的重要性。