Spontaneous Migration of a Peripherally Inserted Central Catheter into the Azygos Vein and Accidental Transection during Thoracic Surgery: A Case Report

This case report presents an incident of spontaneous migration of a peripherally inserted central catheter (PICC) into the azygos vein, leading to accidental transection during surgery. A patient with esophageal cancer had a PICC placed in the left upper arm one day prior to surgery, with the catheter tip confirmed by intracavitary electrocardiogram (IC-ECG) and anterior/lateral chest X-ray imaging. However, during the surgery, the PICC was unintentionally cut when the surgeon isolated and clamped the azygos vein. The surgical team removed the catheter and re-sutured the azygos vein remnant, introducing avoidable risks. This report analyzes the spontaneous migration of the PICC to the azygos vein and explores possible contributing factors to this incident.