A late spontaneous peripherally inserted central catheter migration: two cases series

Abstract

A central venous catheter is a flexible catheter that is inserted into a vein and ends close to the superior vena cava. It may be inserted through a vein in the neck, chest, or arm. It’s also called a central venous line or central line. Peripherally inserted central venous catheters (PICCs) are usually implanted in arm veins such as the basilic vein, the brachial veins or in some cases in the cephalic vein. PICCs can remain in place for up to six months or more. If properly managed, they last even more than a year. PICCs offer the advantage of greater safety for infusion of vesicants/irritants and hyperosmolar solutions and enable the administration of antibiotics, prolonged parenteral nutrition, and chemotherapy agents. They are however, associated with some adverse events such as spontaneous late migration. The reasons for these complications are not yet fully understood. There are now established causes and in some cases hypotheses to explain these phenomena. We describe two clinical cases in which apparently correctly positioned PICCs migrated spontaneously from their original position. The identification of the migration of the vascular catheter was accidental in the two patients, and they did not developed complications. One of the two patients had a pacemaker. The remote migration of a PICC is an event that can occur, and the causes are not definitively clarified in all cases.