Abhishek Kumar's research while affiliated with Tata Main Hospital and other places

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Publications (1)

FIGURE 2: (A) Chest X-ray showing broken PICC line fragments (arrows) in bilateral lungs extending into peripheral pulmonary vasculature; (B) axial CT image revealing the migrating PICC in the right pulmonary artery's right middle lobe segmental branch (arrows). It is also seen extending into the left lower lobe segmental branch of the left pulmonary artery (arrows). The proximal end of the broken PICC was noted in the region of the main pulmonary artery bifurcation; (C) coronal CT image revealing the migrating PICC in the right middle lobe segmental branch of the right pulmonary artery (arrows). It is also seen extending into the left pulmonary artery (arrows); (D) 3D reconstructed CT images revealing the migrated PICC extending into the segmental branches of bilateral pulmonary arteries (arrows) PICC, peripherally inserted central catheter
FIGURE 3: (A) Guidewire positioned in the left pulmonary artery; (B) pigtail catheter hooking the PICC; (C) PICC entangled with the pigtail catheter being pulled out; (D) loop snare catching the entangled PICC
Embolization of a Fractured Peripherally Inserted Central Catheter to Pulmonary Arteries: A Sporadic Life-Threatening Phenomenon
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August 2023

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79 Reads

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3 Citations

Cureus

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Binayendu Prakash

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Shashank Shekhar

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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.

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