Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2024; 12(8): 1430-1436
Published online Mar 16, 2024. doi: 10.12998/wjcc.v12.i8.1430
Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein: A case report
Xiao-Ju Zhu, Ling Zhao, Na Peng, Jia-Min Luo, Shui-Xia Liu
Xiao-Ju Zhu, Ling Zhao, Na Peng, Jia-Min Luo, Shui-Xia Liu, Cancer Center, Daping Hospital, Army Medical University, Chongqing 400042, China
Co-first authors: Xiao-Ju Zhu and Ling Zhao.
Author contributions: Zhu XJ was the patient’s supervisor nurse, who carried out the study, reviewed the literature, contributed to manuscript drafting, and was responsible for revising the manuscript for important intellectual content; Zhao L, Peng N, Luo JM and Liu SX reviewed the literature and contributed to manuscript drafting; Zhu XJ and Zhao L contributed equally to this work as co-first authors; All authors issued final approval for the version to be submitted.
Supported by the Chongqing Medical Scientific Research Project (a joint project of the Chongqing Health Commission and Science and Technology Bureau), No. 2020FYYX046.
Informed consent statement: Written informed consent was obtained for the peripherally inserted central catheter placement.
Conflict-of-interest statement: The authors declare no potential conflicts of interest concerning the research, authorship, and/or publication of this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shui-Xia Liu, RN, Associate Chief Nurse, Cancer Center, Daping Hospital, Army Medical University, No. 10 Changjiang Zhilu, Yuzhong District, Chongqing 400042, China. 529672777@qq.com
Received: October 2, 2023
Peer-review started: October 2, 2023
First decision: December 15, 2023
Revised: December 29, 2023
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: March 16, 2024
Processing time: 161 Days and 19.2 Hours
Abstract
BACKGROUND

Peripherally inserted central catheters (PICCs) are an essential infusion route for oncology patients receiving intravenous treatments, but lower extremity venipuncture is the preferred technique for patients with superior vena cava syndrome (SVCS). We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein, to indicate and verify PICC catheterisation in the lower extremity is safe and feasible. And hope to provide different perspectives for clinical PICC venipuncture to get the attention of peers.

CASE SUMMARY

On 24 August 2022, a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month, which worsened 10 d prior. Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS. Chemotherapy was not an absolute contraindication in this patient. Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head, neck, and upper extremities. The patient and his family were informed about the procedure, and informed consent was obtained. After successful puncture and prompt treatment, the patient was discharged, experiencing some relief from symptoms.

CONCLUSION

Inferior vena cava catheterisation is rare and important for cancer patients with SVCS, particularly in complex situations involving ectopic placement.

Keywords: Superior vena cava syndrome; Peripherally inserted central catheter; Ascending lumbar vein; Complications; Case report

Core Tip: The conventional peripherally inserted central catheter catheterization selected deep venous vessels in the upper limb. Patients with superior vena cava syndrome (SVCS), lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head, neck, and upper extremities. The greater angle of the left lower extremity vein through the common iliac vein into the inferior vena cava and the conundrum that the left side of the femoral vein does not easily enter the inferior vena cava when passing through the common iliac vein, a right lower extremity catheterisation was performed in this case report.