{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:11:30Z","timestamp":1777936290914,"version":"3.51.4"},"reference-count":6,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Vasc Access"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>We present an inadvertent unusual complication of a double square knot found within a PICC in this case report. PICCs are known to cause catheter-related bloodstream infection, catheter malfunction, thromboembolism, catheter migration, and catheter fracture is reported. But the occurrence of double square knot is the rarest complication during insertion which led to unexpected challenges during removal and to our knowledge there are no case reports of this rarest event. We discuss the case presentation, management, and clinical implications of this rare complication.<\/jats:p>","DOI":"10.1177\/11297298251316929","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T03:46:30Z","timestamp":1740368790000},"page":"339-341","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Knot So Simple: A Double Square Knot in a peripherally inserted central catheter (PICC)"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6703-9696","authenticated-orcid":false,"given":"Masilamani","family":"Madivanan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology &amp; Critical Care, DM Critical Care Medicine, AIIMS Jodhpur, Jodhpur, RJ, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3925-9506","authenticated-orcid":false,"given":"Faisal","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology &amp; Critical Care, DM Critical Care Medicine, AIIMS Jodhpur, Jodhpur, RJ, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7588-9017","authenticated-orcid":false,"given":"Bharat","family":"Paliwal","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology &amp; Critical Care AIIMS Jodhpur, Jodhpur, RJ, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231169059"},{"issue":"1","key":"e_1_3_3_3_2","first-page":"1","article-title":"Lower risk of bloodstream infections for peripherally inserted central catheters compared to central venous catheters in critically ill patients","volume":"11","author":"Pitiriga V","year":"2022","unstructured":"Pitiriga V, Bakalis J, Theodoridou K, et al. Lower risk of bloodstream infections for peripherally inserted central catheters compared to central venous catheters in critically ill patients. Antimic Resis Infect Cont. 2022; 11(1): 1\u20137.","journal-title":"Antimic Resis Infect Cont"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejro.2017.09.002"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03018497"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/0019-5049.171580"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000218046.15523.2E"}],"container-title":["The Journal of Vascular Access"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251316929","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/11297298251316929","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/11297298251316929","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:26:07Z","timestamp":1777692367000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/11297298251316929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/11297298251316929"],"URL":"https:\/\/doi.org\/10.1177\/11297298251316929","relation":{},"ISSN":["1129-7298","1724-6032"],"issn-type":[{"value":"1129-7298","type":"print"},{"value":"1724-6032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]}}}