PICC broke into body and taken out by snare: case report and literature review

The catheter breaking into the body is a rare complication. In this report, we described one case in which the Peripherally Inserted Central Catheter (PICC) broke and fell into the body, and then removed by a snare. A 32 year old female suffering from cervical cancer was enrolled in this study. She was catheterized with 4 Fr PICC in the left median vein on April 21, 2014. She fell on the ground by external force at 10:00, June 21, 2014, and felt that the PICC in her left arm moved. She was emergently hospitalized at 16:04, June 21, 2014. Digital subtraction angiography showed that, the PICC fell off and entered the central vein, while its end did not reach the right pulmonary artery. The right femoral vein was punctured and 8F sheath was placed, through which the single bent adapter and guide wire were ascended. The PICC was caught, and then was pulled out of the pulmonary artery, letting its end located inside the right ventricle. EV3 Goose-Neck snare was used to trap the end of PICC. The PICC was slowly dragged out of the sheath. Finally, the sheath was removed. The patients had no intraoperative and postoperative discomfort. This study indicates that, once the PICC breaks and falls off into the patient body, the appropriate medical means should be performed timely to remove the catheter promptly. Meanwhile, the health education should be performed towards the patient.