Clinical A patient admitted to the ICU required a peripherally inserted central catheter (PICC).Chest X-ray (CXR) demonstrated the PICC taking an unusual left parasternal course with the tip posterior to the left ventricle (Figure 1). Blood gas was consistent with venous blood.Figure 1. CXR demonstrating the unusual left parasternal position of the PICC (black arrows) Would you use this PICC line?Answer
1. Demos TC, Posniak HV, Pierce KL, et al. Venous anomalies of the thorax. AJR Am J Roentgenol 2004;182:1139-1150.2. Couvreur T, Ghaye B. Left superior vena cava. In Integrated Cardiothoracic Imaging with MDCT from Medical Radiology. Diagnostic Imaging and Radiation Oncology series. 1st edition. Edited by R\u00e9my-Jardin M, R\u00e9my J. Berlin \u00b7 Heidelberg: Springer-Verlag; 2009:289-305. 3. Povoski SP, Khabiri H. Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011;9:173.
Clinical A patient admitted to the ICU required a peripherally inserted central catheter (PICC).Chest X-ray (CXR) demonstrated the PICC taking an unusual left parasternal course with the tip posterior to the left ventricle (Figure 1). Blood gas was consistent with venous blood.Figure 1. CXR demonstrating the unusual left parasternal position of the PICC (black arrows) Would you use this PICC line?Answer
1. Demos TC, Posniak HV, Pierce KL, et al. Venous anomalies of the thorax. AJR Am J Roentgenol 2004;182:1139-1150.2. Couvreur T, Ghaye B. Left superior vena cava. In Integrated Cardiothoracic Imaging with MDCT from Medical Radiology. Diagnostic Imaging and Radiation Oncology series. 1st edition. Edited by R\u00e9my-Jardin M, R\u00e9my J. Berlin \u00b7 Heidelberg: Springer-Verlag; 2009:289-305. 3. Povoski SP, Khabiri H. Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011;9:173.
Clinical A patient admitted to the ICU required a peripherally inserted central catheter (PICC).Chest X-ray (CXR) demonstrated the PICC taking an unusual left parasternal course with the tip posterior to the left ventricle (Figure 1). Blood gas was consistent with venous blood.Figure 1. CXR demonstrating the unusual left parasternal position of the PICC (black arrows) Would you use this PICC line?Answer
1. Demos TC, Posniak HV, Pierce KL, et al. Venous anomalies of the thorax. AJR Am J Roentgenol 2004;182:1139-1150.2. Couvreur T, Ghaye B. Left superior vena cava. In Integrated Cardiothoracic Imaging with MDCT from Medical Radiology. Diagnostic Imaging and Radiation Oncology series. 1st edition. Edited by R\u00e9my-Jardin M, R\u00e9my J. Berlin \u00b7 Heidelberg: Springer-Verlag; 2009:289-305. 3. Povoski SP, Khabiri H. Persistent left superior vena cava: Review of the literature, clinical implications, and relevance of alterations in thoracic central venous anatomy as pertaining to the general principles of central venous access device placement and venography in cancer patients. World J Surg Oncol. 2011;9:173.
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