PICC line in left-sided SVC
Routine PICC line placement for long term antibiotics.
DSA of thorax, venous injection from PICC
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DSA from the PICC line shows right and left SVCs.
Left SVC is not a rare anomaly (0.5%). It is usually part of a duplication (bilateral SVC), as in this case. The left SVC will rarely drain into the left atrium, and therefore it would be hazardous to leave a PICC line in this position (systemic embolism risk). The demonstration of the pulmonary artery in the second angiogram has important implications for the final position of the PICC.