PMC10194171_01
PICC with entry from the right arm into the superior vena cava (arrows), in a patient with pacemaker.
acc-10-10242-g001.jpg
PMC10194171_01_acc-10-10242-g001.jpg
f1
This showed correct positioning in the superior vena cava (SVC), even though it was difficult to establish the exact position of the tip (Figure 1).
The PICC loops and is in the ipsilateral jugular vein.
acc-10-10242-g002.jpg
PMC10194171_01_acc-10-10242-g002.jpg
f2
Three months later, the patient underwent a chest CT scan, which showed a loop of the PICC, with the tip ascending in the right internal jugular vein (Figure 2).
The PICC has returned to its original position in the superior vena cava (arrows).
acc-10-10242-g003.jpg
PMC10194171_01_acc-10-10242-g003.jpg
f3
After another 3 months, a new chest CT scan was performed on the patient as a follow-up to check the progress of the disease and the tip of the PICC had amazingly returned to its original position in the SVC (Figure 3).
PMC10194171_02
The intracavitary ECG shows the correct positioning of the PICC.
acc-10-10242-g004.jpg
PMC10194171_02_acc-10-10242-g004.jpg
f4
The PICC was inserted with an ultrasound technique and the use of the intracavitary ECG to verify the correct position of the tip (Figure 4).
A chest CT scan shows the correct positioning of the PICC (arrows).
acc-10-10242-g005.jpg
PMC10194171_02_acc-10-10242-g005.jpg
f5
About 2 months after the implant, a chest CT scan was performed as oncological follow-up and this revealed, the correct positioning of the PICC (Figure 5).
A chest CT scan performed subsequently reveals the migration of the PICC into the ipsilateral internal jugular vein.
acc-10-10242-g006.jpg
PMC10194171_02_acc-10-10242-g006.jpg
f6
After 3 months a new chest CT was performed, and this time it showed the migration of the tip of the catheter into the right jugular vein (Figure 6).