Extensive Occlusive Venous Thrombosis of the Left Upper Limb

Clinical History

A 64-year old lady with a peripherally inserted central catheter (PICC line) through her left upper limb, presented with a sudden onset of swelling in her left arm. A vascular ultrasound was requested to rule out thrombosis.

Case Description

Ultrasound revealed an extensive occlusive thrombus in the basilic vein, axillary vein, subclavian vein, and jugular vein of the left side. The PICC line was also visualised within the lumen of the thrombosed vein.

Diagnosis/ Discussion/ Treatment/ Follow up

The insertion of PICC lines can sometimes be for administering certain treatments. Patients who develop any adverse symptom (swelling, pain, redness) post PICC line insertion are prime candidates for an upper limb venous Doppler ultrasound. It is vital to rule out an onset of thrombosis in these patients to avoid dangerous outcomes.