IS Case 384: Arterial placement of PSC line

Penelope Block, MD

2009 URMC Imaging Sciences
Publication Date: 2010-03-02

History

Patient is a 3-day-old premature male seen for evaluation of PSC line placement.

Findings

There is a left PSC line with tip below the level of the heart that does not transverse the right atrium, consistent with arterial line placement instead of venous.

Diagnosis

Arterial placement of PSC line

Discussion

Some of the complications encountered with PSC or PICC line placement include malposition, catheter clotting, bleeding, mechanical phlebitis, and arterial puncture. Complications of arterial line placement include local and distal ischemia or infarction. When the plain film radiograph was reviewed with the NICU team, they reported that the left PSC line was removed due to bright red blood being withdrawn from the catheter consistent with arterial placement.

References

Hogan MJ. Neonatal vascular catheters and their complications. Radiol Clin North Am. 1999 Nov;37(6):1109-25. PMID: 10546669