We present an inadvertent unusual complication of a double square knot found within a PICC in this case report. PICCs are known to cause catheter-related bloodstream infection, catheter malfunction, thromboembolism, catheter migration, and catheter fracture is reported. But the occurrence of double square knot is the rarest complication during insertion which led to unexpected challenges during removal and to our knowledge there are no case reports of this rarest event. We discuss the case presentation, management, and clinical implications of this rare complication.
MaezawaTSakurayaMYoshidaK.The safety of peripherally inserted central venous catheters in critically ill patients: A retrospective observational study. J Vasc Access2024Sep; 25(5): 1479–1485. doi: 10.1177/11297298231169059.
2.
PitirigaVBakalisJTheodoridouK, et al. Lower risk of bloodstream infections for peripherally inserted central catheters compared to central venous catheters in critically ill patients. Antimic Resis Infect Cont. 2022; 11(1): 1–7.
3.
BuijsSBBarentszMWSmitsML, et al. Systematic review of the safety and efficacy of contrast injection via venous catheters for contrast-enhanced computed tomography. Eur J Radiol Open2017; 4: 118-22.
4.
CherianVFaheemM.Knotting of a peripherally inserted central catheter. Can J Anesth. 2004;51(10): 1046–1047.
5.
KabraAPurohitAParasharV.Peripherally inserted central venous catheter line removal leading to brachial vein stripping-Need for more caution. Ind J Anaesth. 2015; 59(12): 814.
