I had an experience today and am hoping that some of you may shed some light on the occurrence. I was placing a PICC line on a gentlemen who had previous PICC's in each arm approx. 1 year ago. He ended up with thrombusÂ in both arms after PICC's placed in these arms. I ready carefully through the venous duplex follow up reports. The last ultrasound of the right arm indicated that no clots or thrombus were present in the right arm. I accessed the basilic vein,which was 3.4cm deep andÂ fully compressed under ultrasound. I accessed the vein and the pt. c/o discomfort, no tingling. The wire threaded beautifully through the needle. I removed the needle and the discomfort went away. I then inserted the introducer. He complained of some discomfort, no tingling. I then threaded the catheterÂ through the dilator approx.15cm. He immediately complained of his arm being "on fire", pain to the arm and itching to the arm. I removed the PICC and dilator immediately. Pt. states that the pain resolved almost immediately but he was experiencing itching to close to the site of insertion. He denied any tingling or numbness. He continues to complain of some itching near that site and some in his hand approx.2 hours after this occurrence.
Could this be the mast cell activation syndrome or related to the previous thrombus from the other PICC's?(again, the right side was clear on the latest report)