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Brachial Pseudoaneurysm and Median Nerve Injury: A Rare Complication of PICC Placement

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by

Vishnu
in

Introduction

Peripherally inserted central catheters (PICCs) have become a widely accepted alternative to conventional central venous catheters, offering benefits such as lower costs, prolonged use, and reduced infection risks. However, despite their advantages, PICC placement is not without complications. A rare but significant risk is injury to adjacent arteries and nerves, as highlighted in a case study published in the Archives of Case Reports.

Visit https://www.hspioa.org/ for more groundbreaking research in this field.

Case Overview: Brachial Artery Pseudoaneurysm and Median Nerve Injury

A 78-year-old woman requiring long-term antibiotic therapy underwent PICC placement in the brachial vein of her right upper limb. Shortly after the procedure, she experienced severe pain, hand movement difficulty, and a large hematoma at the insertion site. Subsequent Doppler ultrasonography revealed a brachial artery pseudoaneurysm.

Key Findings:

  • The pseudoaneurysm was treated successfully with thrombin injection.
  • Despite treatment, the patient experienced persistent neurological deficits due to median nerve injury.
  • The complications were attributed to arterial trauma during catheter insertion, underscoring the importance of ultrasound guidance and post-insertion monitoring.

Understanding the Risks and Best Practices

The American College of Radiology (ACR) emphasizes the importance of careful imaging and guided catheter placements to minimize vascular and nerve-related complications. Despite the benefits of PICCs, awareness of potential adverse events is crucial for healthcare professionals.

Strategic Link Placement

Ensuring Patient Safety: Key Takeaways

  • Ultrasound Guidance: Increases success rates and reduces complications.
  • Post-Procedure Monitoring: Early detection of hematoma formation or neurological deficits is essential.
  • Training and Standardization: Healthcare professionals performing PICC placements should follow standardized protocols to mitigate risks.

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