Immediate Removal of an Entrapped Central Venous Catheter Guide Wire

Extravasal guide wire entrapment due to fraying during central venous catheter placement using the Seldinger technique is a rare complication, which should be resolved as soon as possible. A 68-year-old male was scheduled for open right-side decortication. After the induction of general anesthesia, an attempt was made to place a central venous line in the right subclavian vein. However, the guide wire was entrapped extravasally between the right clavicle and the first rib. The exact site was located by palpating the bend of the guide wire in the subclavian triangle and the thoracic surgeon was available. Therefore, it was decided not to try to visualize the guide wire any further and to immediately proceed with surgical removal of the guide wire. The platysma muscle was dissected allowing access to the subclavian triangle. Venotomy of the external jugular vein was performed and the entrapped guide wire was removed via the venotomy. The whole complication was resolved within 30 minutes and the primary procedure was then performed. Managing rare complications of central venous line placement requires skill, ingenuity and, sometimes, interdisciplinary cooperation, either with a radiologist or a surgeon. The decision to proceed with immediate surgical removal of the guide wire proved a right one, and, to the best of our knowledge, such a strategy has not been described in the relevant literature to date.

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Modified Seldinger technique for internal jugular open central venous line insertion in neonates: merging two different manoeuvers

Egyptian Pediatric Association Gazette ◽

10.1186/s43054-021-00078-8 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Mohamed Mahmoud Shalaby ◽

Rami Mohammed Salama ◽

Mohammed Awad Mansour

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Guide Wire ◽

Venous Catheter ◽

Central Venous Line ◽

Seldinger Technique ◽

Central Venous ◽

Jugular Vein Thrombosis ◽

Line Insertion

Abstract Background Central venous line insertion in neonates is an important and lifesaving procedure. It can carry significant risks and complications, including death, at the time of insertion or later. We aimed to retrospectively assess the modified Seldinger technique for open placement of a central venous catheter in neonates, regarding its safety, feasibility, operative time, and preservation of the patency of the internal jugular vein. This study was conducted on 120 neonates from March 2018 to March 2020. We closely monitored the pulse for the detection of arrhythmia or bradycardia, which might be caused during the insertion of the guide wire or the tip of the catheter. Post-operative X-ray was done immediately after the end of the procedure for all cases, to determine the site of the central venous catheter and to detect the presence of pneumothorax. Results Arrhythmia was observed in 9 cases (7.5%), and blood oozing in 5 cases (4.1%). There were 3 cases of pneumothorax (2.5%), 2 cases of neck hematoma in two cases (1.6%), 6 cases of internal jugular vein thrombosis (5%), and dislodging of the catheter in 3 cases (2.5%). There were no cases of arterial puncture, failure of cannulation, or haemothorax in our study. Conclusions The modified Seldinger technique insertion for open central venous line in neonates is a safe, accessible, and feasible method, especially in centers that lack the experience of ultrasound-guided insertion in neonates.

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Coiling of guide wire in the internal jugular vein during central venous catheter insertion: A rare complication

Indian Journal of Anaesthesia ◽

10.4103/0019-5049.147190 ◽

2014 ◽

Vol 58 (6) ◽

pp. 786 ◽

Cited By ~ 1

Author(s):

RicheekKumar Pal ◽

Baisakhi Laha ◽

Sabyasachi Nandy ◽

Rajasree Biswas

Keyword(s):

Central Venous Catheter ◽

Internal Jugular Vein ◽

Jugular Vein ◽

Guide Wire ◽

Rare Complication ◽

Venous Catheter ◽

Catheter Insertion ◽

Central Venous Catheter Insertion ◽

Central Venous

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Spinal epidural hematoma following removal of incorrectly placed jugular central venous catheter

Journal of Neurosurgery Spine ◽

10.3171/2011.3.spine10900 ◽

2011 ◽

Vol 15 (2) ◽

pp. 206-209 ◽

Cited By ~ 4

Author(s):

Kunio Yokoyama ◽

Masahiro Kawanishi ◽

Makoto Yamada ◽

Hidekazu Tanaka ◽

Yutaka Ito ◽

...

Keyword(s):

Spinal Cord ◽

Central Venous Catheter ◽

Epidural Hematoma ◽

Jugular Vein ◽

Venous Catheter ◽

Central Venous Line ◽

Spinal Epidural Hematoma ◽

Central Venous ◽

The Right ◽

Spinal Epidural

The authors report a rare case of iatrogenic spinal epidural hematoma associated with central venous catheter cannulation via the right internal jugular vein. This 59-year-old man was operated on for stomach cancer while under general anesthesia. A central venous line was inserted via the right internal jugular vein. The operation was completed uneventfully and postoperative fluid replacement was continued without interruption. On postoperative Day 2, marked swelling around the right side of his neck gradually worsened. Cervical CT demonstrated that the catheter tip of the central venous line had penetrated the jugular vein and entered the intervertebral foramen (C5–6), thereby reaching the spinal epidural space. The patient was immediately transported to the operating room and the catheter was carefully extracted under fluoroscopy. Several minutes after catheter removal, the patient complained of sudden severe back pain and over time developed mild paraparesis of both lower extremities. Urgent MR imaging of the spine revealed a large spinal epidural hematoma extending from C-1 to T-8 that was compressing the dorsal spinal cord. The patient underwent emergency surgical removal of the epidural hematoma as well as spinal cord decompression with a T1–4 laminectomy. After surgery, the patient showed full recovery of his lower-extremity motor function.

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Guide Wire Induced Cardiac Tamponade: The Soft J Tip Is Not So Benign

Case Reports in Critical Care ◽

10.1155/2016/1436924 ◽

2016 ◽

Vol 2016 ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Sankalp Dwivedi ◽

Fayez Siddiqui ◽

Milan Patel ◽

Shaun Cardozo

Keyword(s):

Pericardial Effusion ◽

Central Venous Catheter ◽

Cardiac Tamponade ◽

Guide Wire ◽

Rare Complication ◽

Venous Catheter ◽

Transthoracic Echocardiogram ◽

Central Venous ◽

Clinical Stabilization

Central venous catheter (CVC) insertion rarely causes cardiac tamponade due to perforation. Although it is a rare complication, it can be lethal if not identified early. We report a case of cardiac tamponade caused by internal jugular (IJ) central venous catheter (CVC) insertion using a soft J-tipped guide wire which is considered safe and rarely implicated with cardiac tamponade. A bedside transthoracic echocardiogram (TTE) revealed a pericardial effusion with tamponade. An emergent bedside pericardiocentesis was done revealing bloody fluid and resulted in clinical stabilization.

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Insertion of a 1.9F central venous catheter via the internal jugular vein in neonates

Journal of International Medical Research ◽

10.1177/0300060520925380 ◽

2020 ◽

Vol 48 (6) ◽

pp. 030006052092538

Author(s):

Feixiang Luo ◽

Xiaoying Cheng ◽

Xiaofang Lou ◽

Qin Wang ◽

Xiaoyan Fan ◽

...

Keyword(s):

Central Venous Catheter ◽

Success Rate ◽

Internal Jugular Vein ◽

Neonatal Intensive Care ◽

Jugular Vein ◽

Venous Catheter ◽

Seldinger Technique ◽

Central Venous ◽

Minimal Trauma ◽

The Right

Objective This study aimed to develop a technique for placing a 1.9 French (F) central venous catheter in the internal jugular vein of newborns. Methods In this retrospective study, punctures were performed with a modified ultrasound-guided Seldinger technique with 57 1.9F catheters in 48 newborns. Punctures were performed in the right internal jugular vein in 43 (75.4%) patients and in the left internal jugular vein in 14 (24.6%) patients. Results We included 33 (57.9%) boys and 24 (42.1%) girls, aged a median 38 days (range, 2–135 days). The puncture success rate was 100%. Catheterization duration was a median 14 days (range, 1–70 days). Among the catheters, 94.1% were removed after completion of therapy or upon death. Fifty-three (93%) patients experienced no complication, whereas a small amount of bleeding was observed in 2 (3.5%) patients, inflammation of puncture in 1 (1.8%) patient, and occlusion in 1 (1.8%) patient. The method of placement of 1.9F catheters in the internal jugular vein of newborns had a high success rate, with minimal trauma and few complications. Conclusions Our method of placing a 1.9F central venous catheter in the internal jugular vein is suggested for level III to VI neonatal intensive care units.

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An intra-aortic guide wire: what “knot” to do

Cardiology in the Young ◽

10.1017/s1047951119002907 ◽

2019 ◽

Vol 30 (2) ◽

pp. 273-274

Author(s):

Yoshio Ootaki ◽

Gregory A. Ross ◽

Kristen A. Zeller

Keyword(s):

Central Venous Catheter ◽

Guide Wire ◽

Rare Complication ◽

Venous Catheter ◽

Catheter Placement ◽

Central Venous ◽

Central Venous Catheter Placement

AbstractWe report a rare complication of central venous catheter placement in a 5-month-old baby.

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A central venous catheter in the right vertebral vein.

American Journal of Roentgenology ◽

10.2214/ajr.161.4.8372795 ◽

1993 ◽

Vol 161 (4) ◽

pp. 908-908 ◽

Cited By ~ 2

Author(s):

M Kontrus ◽

M L Pretterklieber ◽

M T Farres

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous ◽

The Right

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Successful removal of a central venous catheter misplaced in the right subclavian artery using an intravascular stent: a case report

JA Clinical Reports ◽

10.1186/s40981-021-00418-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Haruka Yoshida ◽

Shinichiro Ikemoto ◽

Yasuyuki Tokinaga ◽

Kanako Ejiri ◽

Tomoyuki Kawamata

Keyword(s):

Central Venous Catheter ◽

Subclavian Artery ◽

Axillary Artery ◽

Insertion Site ◽

Venous Catheter ◽

Central Venous ◽

Thrombotic Complications ◽

Successful Removal ◽

Intravascular Stent ◽

The Right

Abstract Background Cannulation of a central venous catheter is sometimes associated with serious complications. When arterial cannulation occurs, attention must be given to removal of a catheter. Case presentation A 62-year-old man was planned for emergency thoracic endovascular aortic repair. After the induction of anesthesia, a central venous catheter was unintentionally inserted into the right subclavian artery. We planned to remove the catheter. Since we considered that surgical repair would be highly invasive for the patient, we decided to remove it using a percutaneous intravascular stent. A stent was inserted through the right axillary artery. The stent was expanded immediately after the catheter was removed. Post-procedural angiography revealed no leakage from the catheter insertion site and no occlusion of the right subclavian and vertebral arteries. There were no obvious hematoma or thrombotic complications. Conclusions A catheter that has been misplaced into the right subclavian artery was safely removed using an intravascular stent.

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Guide-wire replacement of a mini-midline catheter with a central venous catheter: A retrospective study on 63 cases

The Journal of Vascular Access ◽

10.1177/1129729820944066 ◽

2020 ◽

pp. 112972982094406

Author(s):

Lucio Brugioni ◽

Elisabetta Bertellini ◽

Mirco Ravazzini ◽

Marco Barchetti ◽

Andrea Borsatti ◽

...

Keyword(s):

Central Venous Catheter ◽

Guide Wire ◽

Case Series ◽

Venous Catheter ◽

Venous Access ◽

Late Complications ◽

Central Catheter ◽

Central Venous ◽

Single Lumen ◽

Thrombotic Complications

Background: Achieving a reliable venous access in a particular subset of patients and/or in emergency settings can be challenging and time-consuming. Furthermore, many hospitalized patients do not meet the criteria for central venous catheter positioning, unless an upgrade of the treatment is further needed. The mini-midline catheter has already showed to be reliable and safe as a stand-alone device, since it is easily and rapidly inserted and can indwell up to 1 month. Methods: In this further case series, we retrospectively evaluated data from 63 patients where a previously inserted mini-midline catheter was upgraded to a central venous catheter (the devices inserted in the arm replaced by peripherally inserted central catheter and others inserted “off-label” in the internal jugular replaced by single lumen centrally inserted central catheter), being used as introducer for the Seldinger guidewire. Results: The guidewire replacement was been made even early (after 1 day) or late (more than 10 days), usually following a need for an upgrade in treatment. No early or late complications were reported. Conclusion: According to the preliminary data we collected, this converting procedure seems to be feasible and risk-free, since neither infectious nor thrombotic complications were reported.

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