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Unusual malposition of a peripherally inserted central catheter into the left pericardiophrenic vein: A case report.

Alfonso PianoAnnamaria CarnicelliEmanuele GilardiNicola BonadiaKidane Wolde SellasiePittiruti MauroMariano Alberto Pennisi
Published in: The journal of vascular access (2021)
We report a case of primary malposition of a PICC inserted by guidewire replacement in the emergency room. Intraprocedural tip location by intracavitary electrocardiography was not feasible because the patient had atrial fibrillation; intraprocedural tip location by ultrasound (using the so-called "bubble test") showed that the tip was not in the superior vena cava or in the right atrium. A post-procedural chest X-ray confirmed the malposition but could not precise the location of the tip. A CT scan (scheduled for other purposes) finally visualized the tip in a very unusual location, the left pericardiophrenic vein.
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