Long peripheral catheter replacement through the guidewire in a patient with arteriovenous fistula and inadvertent catheter placement in a perforator – a case report

The intravenous therapy planned by the team determines its duration and the type of solutions administered to the vascular access device. In choosing an appropriate vascular access, patients with chronic kidney disease are a special group. In this group of patients, an arm vein preservation strategy should be implemented due to the possibility of needing an arteriovenous fistula. For expected therapy longer than 5 days, especially in patients with difficult intravenous access, the safest option is a peripherally inserted central catheter, a midline catheter, or a long peripheral catheter. The use of long peripheral catheters, which is prevalent among patients with advanced chronic kidney disease, is associated with a low risks of complications. We present the case of a patient in whom a properly placed catheter in a brachial vein was replaced due to damage to the catheter; however, after replacement, the tip was located in a perforator, which subsequently prevented blood collection.