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Recurrent migration of peripherally inserted central catheter into the azygos vein
  1. Goutham Talari1,2,
  2. Preetham Talari1,
  3. Saurabh Parasramka1,
  4. Aibek E Mirrakhimov1
  1. 1 Department of Internal Medicine, University of Kentucky Medical Center, Lexington, Kentucky, USA
  2. 2 Department of Internal Medicine, Henry Ford Health System, Detroit, Michigan, USA
  1. Correspondence to Dr Goutham Talari, gouthamtalari{at}


Peripherally inserted central catheter (PICC) migration into azygos vein (AV) is a rare complication. It is recognised only when catheter malfunction occurs or when patients develop associated complications. PICC migration into AV has been reported to be associated with various complications such as catheter malfunction, perforation, haemorrhage, thrombosis, infection and stenosis of AV. Pleural effusion and trachea–azygos fistulas have also been reported. We present a patient with recurrent migration of PICC into AV after an initial corrective repositioning during the same hospital stay. In this case, PICC migration was possibly related to left-sided approach, use of smaller diameter PICC, severe congestive heart failure and her bedbound status. PICC migration should be considered when PICC found be malfunctioning, especially if associated with the above risk factors.

  • intravenous / infusion nursing
  • interventional radiology

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  • Contributors GT: identified the condition, literature search and manuscript preparation. PT: literature search, drafting and revising the article. SP: editing of manuscript and final revision. AEM: drafting, editing and revision of manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.