P146 PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER AND PERSISTENT LEFT SUPERIOR VENA CAVA: WHAT SHOULD WE KNOW?

Abstract Peripherally inserted central catheters (PICCs) are widely used medical devices to provide medium long–term infusion treatment and therapy. PICC placement is contraindicated in cases of deep–vein thrombosis, end–stage renal disease or if deep venous access compromised. Among the possible complications there some related interventional procedure (e.g. accidental puncture an arterial vessel, injury peripheral nerves, misplacement, arrhythmias, haematoma) others post–implantation phase infection, gas emboli, phlebitis). One intra–procedural occasional finding a persistent left superior vena cava (PLSVC). PLSVC anatomical variant present at least 0.5% general population its occurrence during procedures not uncommon. Clinical case description An 82–year–old woman was admitted our Institute following diagnosis herpetic encephalitis (HSV1). She had history hypothyroidism undergoing substitution treatment. Cause poor patrimony need therapy with acyclovir, levetiracetam ceftriaxone, indication for implantation given. After antibiotic prophylaxis sterile field preparation, performed ultrasound–guided Seldinger technique by puncturing basilic vein. A successive X–ray showed running unusually parallel right sternum (Fig. 1). The echoscopy bubble test allowed visualize agitated saline solution atrium. In view suspected abnormality, removed single–lumen MiniMidline 4F 11 cm length placed vein (4 mm). subsequent chest CT scan visualised intrathoracic course, presence also observed 2). encountered involving peripherally catheters. It important recognise this avoid procedural and/or post–procedural surgical complications.