Abstract
Aim. Accurate tip positioning of peripherally inserted central catheters (PICCs) is essential for safe intravenous therapy. While intracavitary ECG (IC-ECG) is a recommended method for tip confirmation, access to compatible systems may be limited in clinical practice. The aim of this case report is to describe the use of the Vygocard™ system as an alternative method for tip confirmation during the Groshong™ PICC insertion.
Material and methods. We present a case of a 70-year-old oncology patient requiring removal of a totally implantable vascular access device due to infection, followed by insertion of a PICC Groshong™ for continued chemotherapy. As the Groshong™ catheter lacks a dedicated IC-ECG system, the Vygocard™ device was used with continuous saline infusion to enable electric signal conduction.
Results. Real-time monitoring with Vygocard™ confirmed correct catheter tip position at the cavo-atrial junction based on P-wave morphology changes. Chest X-ray post-procedure verified accurate placement. The catheter functioned effectively and was later removed without complications.
Conclusions. This case illustrates the successful off-label use of Vygocard™ for tip confirmation in a Groshong™ PICC. The approach may serve as a safe and effective alternative when dedicated systems are unavailable.