case_images: PMC10194171_01
case_images: PICC with entry from the right arm into the superior vena cava (arrows), in a patient with pacemaker.
case_images: acc-10-10242-g001.jpg
case_images: PMC10194171_01_acc-10-10242-g001.jpg
case_images: f1
case_images: This showed correct positioning in the superior vena cava (SVC), even though it was difficult to establish the exact position of the tip (Figure 1).
case_images: The PICC loops and is in the ipsilateral jugular vein.
case_images: acc-10-10242-g002.jpg
case_images: PMC10194171_01_acc-10-10242-g002.jpg
case_images: f2
case_images: Three months later, the patient underwent a chest CT scan, which showed a loop of the PICC, with the tip ascending in the right internal jugular vein (Figure 2).
case_images: The PICC has returned to its original position in the superior vena cava (arrows).
case_images: acc-10-10242-g003.jpg
case_images: PMC10194171_01_acc-10-10242-g003.jpg
case_images: f3
case_images: After another 3 months, a new chest CT scan was performed on the patient as a follow-up to check the progress of the disease and the tip of the PICC had amazingly returned to its original position in the SVC (Figure 3).
case_images: PMC10194171_02
case_images: The intracavitary ECG shows the correct positioning of the PICC.
case_images: acc-10-10242-g004.jpg
case_images: PMC10194171_02_acc-10-10242-g004.jpg
case_images: f4
case_images: The PICC was inserted with an ultrasound technique and the use of the intracavitary ECG to verify the correct position of the tip (Figure 4).
case_images: A chest CT scan shows the correct positioning of the PICC (arrows).
case_images: acc-10-10242-g005.jpg
case_images: PMC10194171_02_acc-10-10242-g005.jpg
case_images: f5
case_images: About 2 months after the implant, a chest CT scan was performed as oncological follow-up and this revealed, the correct positioning of the PICC (Figure 5).
case_images: A chest CT scan performed subsequently reveals the migration of the PICC into the ipsilateral internal jugular vein.
case_images: acc-10-10242-g006.jpg
case_images: PMC10194171_02_acc-10-10242-g006.jpg
case_images: f6
case_images: After 3 months a new chest CT was performed, and this time it showed the migration of the tip of the catheter into the right jugular vein (Figure 6).