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

Abstract

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.

Should a forgotten guidewire be removed after years? An undesirable complication of hemodialysis catheter wire left in the body

“…There are reports of guide wire migration in the body (5,10) or stroke in the brain (9), or the formation of a clot on it and sending an embolism or the development of endocarditis (the reported case). They can all endanger patients' lives.…”

“…Complications of guide wire loss include the migration of the guide wire to the pulmonary artery (5), guidewire knocking (6), a broken guidewire (7), arteriovenous fistula (8), and cerebral stroke (9). The guidewire can migrate to different places, such as from femoral to jugular (10), or infection and endocarditis (the presented case) (11,12).…”