title: Spontaneous migration of a peripherally inserted central catheter into the azygos vein in esophageal cancer patients during surgery.
abstract: BACKGROUND
  A peripherally inserted central catheter (PICC) is widely used for long chemotherapy regimens or total parenteral nutrition. However, spontaneous migration of the catheter into the azygos vein after satisfactory initial placement has occurred in rare cases.
  
  
  METHODS
  We discuss three such cases in esophageal cancer patients.
  
  
  RESULTS
  In two patients, the migrated catheters were found during surgery and were repositioned without complications. However, in the third case, the migrated catheter had to be removed to avoid severe complications, as the catheter and the azygos vein were ligatured during operation without notice.
  
  
  CONCLUSIONS
  Migrations might be related to the material properties of silicone PICCs, the short insertion length, the left-sided placement, the changes of thoracic pressure and the intraoperative traction by thoracic surgeons. In conclusion, we recommend routine checks before cutting off the azygos vein during the operations for esophageal cancer patients with left-sided PICCs.
authors.affiliation: Department of Radiotherapy, Cancer Hospital of Sichuan Province, Chengdu - China.
authors.forename: Hanfeng
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Cancer Hospital of Sichuan Province, Chengdu - China.
authors.forename: Bin
authors.initials: B
authors.lastname: Jiang
authors.affiliation: Department of Thoracic Surgery, Cancer Hospital of Sichuan Province, Chengdu - China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Medical Oncology, Cancer Hospital of Sichuan Province, Chengdu - China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Qin
authors.affiliation: Department of Nursing, Cancer Hospital of Sichuan Province, Chengdu - China.
authors.forename: Guorong
authors.initials: G
authors.lastname: Wang
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001401:Azygos Vein / Q000000981:diagnostic imaging / Q000601:surgery; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D002408:Catheters, Indwelling; D062905:Central Venous Catheters; D020878:Device Removal; D004867:Equipment Design; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005548:Foreign-Body Migration / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents