CASE REPORT article
Front. Oncol.
Sec. Cancer Imaging and Image-directed Interventions
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1656941
Case report: Successful DSA-guided removal of a fractured PICC catheter from the pulmonary artery in a patient with lung cancer
Provisionally accepted
- 1West China Hospital, Sichuan University, Chengdu, China
- 2Chinese People's Liberation Army Western Theater General Hospital, Chengdu, China
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Background: Peripherally inserted central catheters (PICCs) are widely used for long-term intravenous therapy, especially in cancer patients. Although generally safe, PICC-related complications such as catheter fracture and migration can pose serious risks. Case presentation: We report a case of a 41-year-old female with lung adenocarcinoma who developed PICC catheter fracture, with the broken segment migrating into the pulmonary artery during chemotherapy. The patient presented without significant symptoms, and imaging confirmed the intravascular migration of the catheter fragment. After multidisciplinary evaluation, the fractured catheter was successfully removed under digital subtraction angiography (DSA) guidance via a minimally invasive endovascular approach. The patient recovered uneventfully. Conclusion: This case highlights the rare but serious complication of PICC catheter fracture with subsequent migration into the pulmonary artery during chemotherapy in a patient with lung adenocarcinoma. Prompt identification and multidisciplinary management, including minimally invasive retrieval under DSA guidance, ensured a favorable outcome and avoided major morbidity. The experience underscores the importance of standardized PICC maintenance protocols, comprehensive training of nursing staff, and patient education on self-care to minimize preventable complications. Furthermore, our findings emphasize the need for regular catheter monitoring and timely intervention when abnormalities are detected. Minimally invasive endovascular techniques represent a well-documented, safe and effective alternative to traditional surgical methods for the retrieval of intravascular foreign bodies, with advantages of reduced trauma, faster recovery, and fewer complications. Continued efforts to enhance nursing skills, strengthen follow-up, adopt polyurethane catheters instead of silicone PICC per current guidelines, and promote patient awareness are essential to improve the safety and success rates of PICC utilization in cancer populations requiring long-term intravenous access.
Keywords: lung cancer, chemotherapy, Digital subtraction angiography, peripherally insertedcentral catheter, case report
Received: 30 Jun 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Lai, Xiao, Wen, Zhang, Meng and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenjun Meng, West China Hospital, Sichuan University, Chengdu, China
Rujun Zheng, West China Hospital, Sichuan University, Chengdu, China
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