Accidental guide wire migration and late percutaneous externalization after central venous catheterization

2021 ◽  
pp. 112972982110548
Author(s):  
Petra Cristina van den Bogert ◽  
Walter Junior Boim de Araujo ◽  
Viviane Gomes Milgioransa Ruggeri ◽  
Filipe Carlos Caron ◽  
Fabiano Luiz Erzinger ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Guide Wire ◽  
Femoral Vein ◽  
Invasive Procedure ◽  
Venous Catheter ◽  
Hemodynamic Instability ◽  
Central Venous ◽  
Post Discharge ◽  
Venous Catheterization ◽  
The Right

A 70-year-old man was admitted to the emergency department with recent spontaneous externalization of a metallic device from his right inner thigh. He had been experiencing mild local pain for 2 weeks and had a recent hospitalization due to cardiogenic hemodynamic instability, requiring a central venous catheter placement in his right internal jugular vein 3 months earlier. Doppler ultrasound confirmed the intravascular foreign body hypothesis as a guidewire was identified inside the right femoral vein, associated with femoropopliteal venous thrombosis. The guidewire was successfully removed percutaneously through simple manual traction guided by radioscopy. The patient was discharged the following day on oral anticoagulation with rivaroxaban. On outpatient follow-up 4 weeks post discharge, he had no complaints in the right lower limb except for slight swelling. Central venous catheterization is a common invasive procedure that, although unquestionably safe and well stablished in medical practice, can lead to serious complications when performed without proper technique.

scholarly journals Identification and correction of guide wire malposition during internal jugular cannulation with ultrasound

CJEM ◽  
2007 ◽  
Vol 9 (02) ◽  
pp. 131-132 ◽  
Author(s):  
Michael B. Stone
Keyword(s):  
Real Time ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Venous Catheter ◽  
Central Venous ◽  
Venous Catheterization ◽  
Procedural Complications ◽  
Introducer Needle ◽  
Wire Resistance

ABSTRACT Real-time ultrasound guidance for central venous catheterization increases success and reduces procedural complications. I describe a case in which guide wire resistance was encountered and real-time ultrasound visualization of the guide wire facilitated correction of guide wire malposition. No additional passes of the introducer needle were necessary and the chances of inadvertent carotid artery puncture or pneumothorax were therefore reduced. The technique described here may prove valuable when guide wire resistance is encountered while placing a central venous catheter.

scholarly journals Covid-19 and a lost guidewire: A misty tale of misery!

2021 ◽  
Vol 8 (4) ◽  
pp. 54-57
Author(s):  
Abhijit Kumar ◽  
Parul Tripathi ◽  
Suman Tiwari ◽  
Malvika Gupta ◽  
Amit Kohli ◽  
...  
Keyword(s):  
Central Venous Catheterization ◽  
Guide Wire ◽  
Femoral Vein ◽  
Seldinger Technique ◽  
Protective Equipment ◽  
Fluoroscopic Guidance ◽  
Routine Procedure ◽  
Central Venous ◽  
Interventional Radiologist ◽  
Venous Catheterization

 Central venous catheterization (CVC) is a routine procedure in patients admitted in Intensive Care Units (ICU) worldwide. Most commonly, seldinger technique is being practiced irrespective of the site of insertion. Though considered very safe, guide wire related complications have been reported in the literature and incidence has increased in the COVID era where intensivists have to work in personal protective equipment (PPE).  We are reporting about a patient of severe COVID-19, admitted in ICU. His right femoral venous catheterization was done to start vasopressors. The guide wire accidentally slipped inside the femoral vein during the procedure. It was immediately detected and managed with the assistance of interventional radiologist under fluoroscopic guidance. Complications like misplacement of guide wire can be catastrophic during CVC. We have discussed the measures that can prevent or reduce such complications while working in PPE in COVID ICUs.

scholarly journals Coiling of shaft of the central venous catheter inside left subclavian vein- a case report

2018 ◽  
Vol 4 (2) ◽  
pp. 87-90
Author(s):  
Lalit Kumar Rajbanshi ◽  
Shambhu Bahadur Karki ◽  
Batsalya Arjyal
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Venous Catheter ◽  
Anatomical Landmarks ◽  
Central Venous ◽  
Venous Catheterization ◽  
Left Subclavian Vein ◽  
The Common ◽  
Blood Aspiration

Central venous catheterization is one of the common procedures used for gaining vascular access for various indications. Sometimes, the catheter can take unusual course inside the vein that can lead to erroneous pressure measurement, increase the risk of thrombosis or trauma to the vessel. Any resistance during insertion of the guide wire or catheter and absence of blood aspiration are some alarming signs that help to detect malposition at the earliest moment. We report a case of coiling of the shaft of the central venous catheter inside left sublacvian vein in a patient with head injury. Technical expertise, sound knowledge of anatomical landmarks and use of real time ultrasound can minimize malposition of the catheter. We suggest at any moment if there is resistance during insertion of guide wire or catheter or if there is absence of blood aspiration from any of the lumen, the catheter should be removed immediately suspecting malposition.Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, page: 87-90 

Misplacement of a central venous catheter into azygos vein via the right internal jugular vein

2020 ◽  
pp. 112972982095099
Author(s):  
Minjia Wang ◽  
Liang Xu ◽  
Yue Feng ◽  
Shijin Gong
Keyword(s):  
Central Venous Catheter ◽  
Critically Ill Patients ◽  
Central Venous Catheterization ◽  
Jugular Vein ◽  
Venous Catheter ◽  
Azygos Vein ◽  
Central Venous ◽  
Venous Catheterization ◽  
Tip Position ◽  
The Right

For critically ill patients, central venous catheterization may not always be placed in a correct tip position, even when guided by ultrasound. A case of inadvertent catheterization into azygos vein is described.

scholarly journals A Catastrophe Caused by Central Venous Catheter Insertion – A Case Report

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Cardiac Arrhythmias ◽  
Inferior Vena ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Vena Cava ◽  
Air Embolism ◽  
Venous Catheter ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
Venous Catheterization

Central venous catheterization (CVC) is a routine technique done in critical care and emergency departments for monitoring patients and giving certain parenteral medications in special conditions. Most common complications associated with CVCs are infection, hematoma, hemothorax, pneumothorax and superior or inferior vena cava trauma while rare complications include cardiac arrhythmias, air embolism and loss of the guide wire [1].

scholarly journals Depth of Central Venous Catheterization: An Audit of Practice in a Cardiac Surgical Unit

1994 ◽  
Vol 22 (3) ◽  
pp. 267-271 ◽  
Author(s):  
J. S. Rutherford ◽  
A. F. Merry ◽  
C. J. Occleshaw
Keyword(s):  
Central Venous Catheterization ◽  
Main Bronchus ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Azygos Vein ◽  
Central Venous ◽  
Venous Catheterization ◽  
The Right ◽  
Surgical Unit

Central venous catheter (CVC) depth relative to the cephalic limit of the pericardial reflection (CLPR) was assessed retrospectively in 100 adult patients from chest radiographs taken after admission to the intensive care unit. A well known landmark proved to be considerably influenced by parallax; therefore we located the CLPR by a new landmark, the junction of the azygos vein and the superior vena cava, identified by the angle of the right main bronchus and the trachea. The majority (58) of CVC tips lay below the pericardial reflection on the first chest radiograph (CXR). Of these only two had been corrected by the time of the next routine CXR. No case of cardiac tamponade secondary to erosion by a CVC could be remembered, or identified from records of routine departmental audit meetings, for the last ten years. Nevertheless, reported incidents of this complication have often been fatal and vigilance is necessary in any patient with a CVC.

scholarly journals Comparative Analysis of Ultrasound Guided Central Venous Catheterization Compared to Blind Catheterization

PRILOZI ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Darko Sazdov ◽  
Marija Jovanovski Srceva ◽  
Zorka Nikolova Todorova
Keyword(s):  
Real Time ◽  
Complication Rate ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Femoral Vein ◽  
Venous Catheter ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Venous Catheterization ◽  
A Prospective Study

Abstract Introduction: Central venous catheterization is performed by the landmark method and ultrasound guided method. The purpose of the study was to compare the success, average number of attempts, average time to return of blood, and complication rate between the two methods. Material and Methods: This was a prospective study done in the Intensive Care Unit of the Acibadem Sistina Clinical Hospital, in Skopje. There were 400 patients in need of central venous catheter and they were prospectively randomized in two groups. The patients randomized in the examined-ultrasound group underwent real-time ultrasound-guided catheterization and the patients randomized in the control-landmark group were catheterized using the landmark method. Internal Jugular, Subclavian and Femoral vein were catheterized in both groups. The Overall success, success on the first attempt, time to the return of blood, number of attempts and complications at the moment of catheterization such as arterial puncture, pneumothorax and hematoma formation were the main outcome measures. Results: The catheterization using the landmark method was successful in 90.5% of patients, 60.5% of which during the first attempt. The cannulation using real-time ultrasound guidance was successful in 98% of patients with a first pass success of 77%. The complication rate with the landmark method was 14.5% versus 4% with real-time ultrasound guidance p<0.05(p=0.0008). Conclusion: Real-time ultrasound guidance improves success, decreases number of attempts, decreases average time to the return of blood and reduces mechanical complications rate.

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