Forgotten guidewire: A case report. (July 2022)

• Record Type: Journal Article
• Authors: Alves Ramos Diniz, Paulo Inácio; Rios Rodriguez, Juan Eduardo; Salgado Pio Oliveira, João Pedro; Cruz Lira, Mirella; Lima da Rocha, Renan Danilo; Ribeiro dos Santos Campelo, Priscilla; da Costa Matos, Juliana; Pessoa Cavalcante, Leonardo
• Is Part Of: Annals of medicine and surgery. Volume 79(2022)
• Publication Date: 2022-07
• Subjects: Vascular access devices -- Vascular system injuries -- Vascular surgical procedures -- Case reports; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.103867
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Introduction: The Seldinger technique for implanting central venous catheters is the most used in the world. A metallic guidewire is employed in it, introduced through the lumen of a venipuncture needle, which serves as a path for the introduction of the central venous catheter. Complications directly related to this technique are of several types, such an insertion of a long-winded segment of the guidewire, which can lead to venous perforation, cardiac perforation, arrhythmias or even guidewire retention/embolization. Presentation of the case: We report the case of a patient with a late diagnosis of a guidewire retained in her venous system. The distal end of the guidewire pierced the pulmonary artery, crossed the chest wall and remained in the left breast tissue. It was removed by laparotomy, through an extra-peritoneal access to the right common iliac vein. Discussion: Different factors have been identified as responsible for the increase in the number of guidewires retained after central venous catheterizations. Lack of supervision, in procedures performed by training physicians, has been identified as one of the most important risk factor in the cases reported in the literature. Conclusion: The present report demonstrates that central venous catheterization, despite being a relatively straight forward procedure, should not be underestimated and should be performed by properly trained physicians or by training physicians under supervision. Highlights: Retained guidewire is a rare complication. There are several factors for guidewire migration. Central venous catheterization should not be underestimated.