Brachial Arteriovenous Fistula as a Complication of Placement of a Peripherally Inserted Central Venous Catheter: A Case Report and Review of the Literature
Restricted accessResearch articleFirst published online September, 2006
Brachial Arteriovenous Fistula as a Complication of Placement of a Peripherally Inserted Central Venous Catheter: A Case Report and Review of the Literature
Peripherally inserted central venous catheter (PICC) lines have become a frequently used method of intravenous access for long-term administration of antibiotics, chemotherapy, and parenteral nutrition. Catheter-related complications involving the arterial tree are rare. We report a case of a 25-year-old woman with a history of difficult PICC line placement that presented with an arteriovenous fistula in the left arm. Duplex ultrasound confirmed the diagnosis of a brachial artery-to-brachial vein arteriovenous fistula (AVF), and the patient underwent surgical repair. To our knowledge, this is the first reported case of an AVF resulting from PICC line placement. Correction of AVF is indicated to alleviate symptoms as well as to prevent future complications.
HoshalV.L.Total intravenous nutrition with peripherally inserted silicone elastomer central venous catheters.Arch Surg1975; 100: 644–6.
3.
JanesM., KalynA., PinelliJ., PaesB.A randomized trial comparing peripherally inserted central venous catheters and peripheral intravenous catheters in infants with very low birth weight.J Pediatr Surg2000; 35: 1040–4.
4.
FunkD., GrayJ., PlourdeP.J.Two-year trends of peripherally inserted central catheter-line complications at a tertiary-care hospital: role of nursing expertise.Infect Control Hosp Epidemiol2001; 22: 377–9.
5.
HorattasM.C., TrupianoJ., HopkinsS.Changing concepts in long-term central venous access: catheter selection and cost savings.Am J Infect Control2001; 29: 32–40.
6.
FongN.I., HoltzmanS.R., BettmanM.A., BettisS.J.Peripherally inserted central catheters: outcome as a function of the operator.J Vasc Interv Radiol2001; 12: 723–9.
7.
AlhimyaryA., FernandezC., PicardM.Safety and efficacy of total parenteral nutrition delivered via a peripherally inserted central venous catheter.Nutr Clin Pract1996; 11: 199–203.
8.
MillerK.D., DietrickC.L.Experience with PICC at a university medical center.J Intraven Nurs1997; 20: 141–7.
9.
ArmstrongP.J., HanD.C., BaxterJ.A.Complication rates of percutanous brachial artery access in peripheral vascular angiography.Ann Vasc Surg2003; 17: 107–10.
10.
BottinoJ., McCredieK.B., GroschelD.H., LawsonM.Long-term intravenous therapy with peripherally inserted silicone elastomer central venous catheters in patients with malignant diseases.Cancer1979; 43: 1937–43.
11.
SchumanE., BradyA., GrossG., HayesJ.Vascular access options for outpatient cancer therapy.Am J Surg1987; 153: 487–9.
12.
GrahamD.R., KeldermansM.M., KlemmL.W.Infectious complications among patients receiving home intravenous therapy with peripheral, central, or peripherally placed central venous catheters.Am J Med1991; 91: 95S–100S.
13.
GoodwinJ.L., CarlsonI.The peripherally inserted central catheter: a retrospective look at three years of insertions.J Intraven Nurs1993; 16: 92–103.
14.
LamS., ScannellR., RoesslerD., SmithM.A.Peripherally inserted central catheters in an acute-care hospital.Arch Intern Med1994; 154: 1833–7.
15.
LoughranS.C., BorzattaM.Peripherally inserted central catheters: a report of 2506 catheter days.J Parenter Enteral Nutr1995; 19: 133–6.
16.
MerrellS.W., PeatrossB.G., GrossmanM.D.Peripherally inserted central venous catheters: low-risk alternatives for ongoing venous access.West J Med1994; 160: 25–30.
17.
CardellaJ.F., CardellaK., BacciN.Cumulative experience with 1273 peripherally inserted central catheters at a single institution.J Vasc Interv Radiol1996; 7: 5–13.
18.
NgP.K., AultM.J., EllrodtA.G., MaldonadoL.Peripherally inserted central catheters in general medicine.Mayo Clin Proc1997; 72: 225–33.
AllenA.W., MegargellJ.L., BrownD.B.Venous thrombosis associated with the placement of peripherally inserted central catheters.J Vasc Interv Radiol2000; 11: 1309–14.
21.
KelmM., PeringsS.M., JaxT.Incidence and clinical outcome of iatrogenic femoral arteriovenous fistulas: implications for risk stratification and treatment.J Am Coll Cardiol2002; 40: 291–7.
22.
OntellS.J., GaudererM.W.Iatrogenic arteriovenous fistula after multiple arterial punctures.Pediatrics1985; 76: 97–8.
23.
LalljeeN.Iatrogenic arteriovenous fistula: an unusual complication of cardiac catheterization.J Cardiovasc Surg (Torino)1970; 11: 246–8.
24.
CirilloR.L., FontaineA.B.Iatrogenic brachiocephalic arteriovenous fistula: description of a fatal complication after cardiac pacemaker lead extraction.J Vasc Interv Radiol1998; 9: 1029–30.
25.
NorcrossW.A., ShackfordS.R.Arteriovenous fistula: a potential complication of venipuncture.Arch Intern Med1988; 148: 1815–6.
FeldR., PattonG.M., CarabasiR.A.Treatment of iatrogenic femoral artery injuries with ultrasound-guided compression.J Vasc Surg1992; 16: 832–40.
30.
ChrismanH.B., OmaryR.A., NemcekA.A.Peripherally inserted central catheters: guidance with uses of US versus venography in 2650 patients.J Vasc Interv Radiol1999; 10: 473–5.
31.
BuntingJ., SlaughterR.E., MaselP.J.Ultrasound placement of peripherally inserted central catheters (PICCs) in adults with cystic fibrosis.Thorax2000; 55: 535.
