Delayed diagnosis of a retained guidewire after bedside femoral venous catheter insertion: A preventable complication

Abstract

Central venous catheter (CVC) insertion is a commonly performed procedure that is used for continuous invasive hemodynamic monitoring, fluid resuscitation, drug therapy, and hemodialysis. CVC placement can be associated with serious complications that are mostly preventable. One of these complications is the loss of the guidewire within the intravascular space, which carries a high morbidity and mortality. Here, we describe a 44-year old patient who presented with acute kidney injury and metabolic derangements that necessitated bedside right femoral dialysis catheter to initiate emergent renal replacement therapy. A day after the catheter insertion, the guidewire was noted on a routine chest X-ray extending into the base of the skull. The clinical course was complicated with cerebral infarction. Subsequently, the retained guidewire was removed a few days after the CVC insertion. In summary, the retained guidewire within the circulation is associated with potentially life-threatening and hazardous outcomes. Continuing education, vigilant supervision, and implementing certain protocols are likely to prevent such undesirable events.

Loss of a Guidewire During Central Venous Catheter Insertion Into the Right Internal Jugular Vein

“…The Seldinger method is the recommended approach for placement due to its recognized safety. Despite its routine nature, the procedure is not without risks, and complications may arise in as many as 15% of these procedures [1,2]. Complications related to the guidewire are among these risks, holding the potential for serious outcomes and increased morbidity and mortality [1][2][3][4].…”

“…Despite its routine nature, the procedure is not without risks, and complications may arise in as many as 15% of these procedures [1,2]. Complications related to the guidewire are among these risks, holding the potential for serious outcomes and increased morbidity and mortality [1][2][3][4]. This article presents a case involving the loss of a guidewire during ultrasound-guided central venous catheter (CVC) insertion into the right internal jugular vein of a patient during her extended hospital stay.…”

Percutaneous Fluoroscopy Guided Retrieval of a Fractured Pelvic Drain Post Caesarean Section: A Case Report

“…Traditionally, surgical re-exploration through open surgery has been the mainstay technique for retrieval of the severed retained drains from the abdominal and pelvic cavities. 4 The complications can range from patients remaining completely asymptomatic 5 to severe morbidity 6 and mortality. 7 We present a case report of a fractured pelvic drain retrieved through a percutaneous approach under fluoroscopic guidance.…”