Vascular Perforation by a Peripherally Inserted Central Venous Catheter That Was Suspected Based on the Ineffectiveness of a Muscle Relaxant Drug：A Case Report

Abstract

A 68-year-old woman underwent placement of a peripherally inserted central venous catheter （PICC） from her left basilic vein to administer antibiotics for treatment of postoperative wound infection on postoperative day 54. On postoperative day 101 when she underwent skin grafting, it was found that muscle relaxant administered through PICC during induction of general anesthesia showed no effect. After the skin grafting, plain CT was performed and extravascular perforation of PICC was confirmed. When no backward blood flow from PICC or no administered drug effect through PICC is found, image inspection for abnormal catheter tip positioning of PICC has to be performed. When PICC perforation is confirmed, careful therapeutic plan after PICC removal including need for surgical hemostasis should be considered prior to PICC removal.