Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jan 23:2018:bcr2017221184.
doi: 10.1136/bcr-2017-221184.

Recurrent migration of peripherally inserted central catheter into the azygos vein

Goutham Talari  1   2 , Preetham Talari  1 , Saurabh Parasramka  1 , Aibek E Mirrakhimov  1
Affiliations
Case Reports

Recurrent migration of peripherally inserted central catheter into the azygos vein

Goutham Talari et al. BMJ Case Rep. .

Abstract

Peripherally inserted central catheter (PICC) migration into azygos vein (AV) is a rare complication. It is recognised only when catheter malfunction occurs or when patients develop associated complications. PICC migration into AV has been reported to be associated with various complications such as catheter malfunction, perforation, haemorrhage, thrombosis, infection and stenosis of AV. Pleural effusion and trachea-azygos fistulas have also been reported. We present a patient with recurrent migration of PICC into AV after an initial corrective repositioning during the same hospital stay. In this case, PICC migration was possibly related to left-sided approach, use of smaller diameter PICC, severe congestive heart failure and her bedbound status. PICC migration should be considered when PICC found be malfunctioning, especially if associated with the above risk factors.

Keywords: interventional radiology; intravenous / infusion nursing.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Portable anteroposterior view of chest X-ray confirming the appropriate position of PICC tip in SVC after initial placement. PICC, peripherally inserted central catheter; SVC, superior vena cava.
Figure 2
Figure 2
Portable anteroposterior view of chest X-ray showing initial migration of PICC tip likely into AV. AV, azygos vein; PICC, peripherally inserted central catheter.
Figure 3
Figure 3
Portable anteroposterior view of chest X-ray showing correction of PICC tip position from AV into SVC after a saline flush. AV, azygos vein; PICC, peripherally inserted central catheter; SVC, superior vena cava.
Figure 4
Figure 4
Portable anteroposterior view of chest X-ray showing recurrent migration of PICC tip in to AV. AV, azygos vein; PICC, peripherally inserted central catheter.
See this image and copyright information in PMC

References

    1. Woller SC, Stevens SM, Evans RS. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) initiative: a summary and review of peripherally inserted central catheter and venous catheter appropriate use. J Hosp Med 2016;11:306–10. 10.1002/jhm.2525 - DOI - PubMed
    1. Hobeika J, Serri K, Albert M. Development of a standardized method of peripherally inserted central catheter (PICC-line) bedside installation. Critical Care 2014;18(Suppl 1):P128 10.1186/cc13318 - DOI
    1. Mou QQ, Wang YX, Xu QH, et al. . Nerve damage secondary to removal of fractured PICC fragment. J Vasc Access 2016;17:e79–81. 10.5301/jva.5000551 - DOI - PubMed
    1. Franklin I, Gilmore C. Placement of a peripherally inserted central catheter into the azygous vein. J Med Radiat Sci 2015;62:160–2. 10.1002/jmrs.98 - DOI - PMC - PubMed
    1. Zhou Q, Murthy S, Pattison A, et al. . Central venous access through a persistent left superior vena cava: a case series. J Vasc Access 2016;17:e143–7. 10.5301/jva.5000554 - DOI - PubMed

Publication types