Late neurological deficit after attempted PICC insertion in the arm

Author:

Antunes Bruno FF1,Machado Andrea MN2,Miziara Roberta A3,Liao Adolfo W4,Mendes Cynthia A5,Wolosker Nelson6,Teivelis Marcelo P5

Affiliation:

1. Vascular Surgery Medical Resident, Hospital Israelita Albert Einstein, São Paulo, Brazil

2. Obstetrics Staff, Hospital Municipal Vila Santa Catarina / Hospital Israelita Albert Einstein, São Paulo, Brazil

3. Gynecology and Obstetrics Medical Resident, Hospital Israelita Albert Einstein, São Paulo, Brazil

4. Head of Obstetrics, Hospital Municipal Vila Santa Catarina / Hospital Israelita Albert Einstein, São Paulo, Brazil

5. Vascular Surgeon, Hospital Municipal Vila Santa Catarina / Hospital Israelita Albert Einstein, São Paulo, Brazil

6. Vascular Surgeon at Hospital Israelita Albert Einstein, São Paulo, Brazil

Abstract

Introduction: Insertion of central catheters in peripheral vessels is a common procedure performed for a variety of indications, including parenteral nutrition. Hyperemesis gravidarum may require parenteral nutrition in exceptional situations. Although globally safe, insertion of peripherally inserted central catheters (PICCs) can lead to complications. Case Report: We describe a case of a pregnant woman who required parenteral nutrition and underwent an unsuccessful PICC insertion attempt resulting in arterial puncture, and who 34 days later presented with right upper limb paresthesia. A pseudoaneurysm with nerve compression was diagnosed and treated by open surgery, without maternal or fetal complications. Conclusion: We recommend active surveillance ultrasound (e.g. in the first 24–48 h) of unsuccessful PICC insertion attempts, because late complications may occur and require invasive procedures for treatment.

Publisher

SAGE Publications

Subject

Nephrology,Surgery

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