Kinking, unwinding and retrieval of the Seldinger guide wire

Dubey, Prakash K.

doi:10.4103/0970-9185.142883

Cited by 3 publications

(2 citation statements)

References 4 publications

(5 reference statements)

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“…Kinking of the guidewire can potentially misdirect the tissue dilator and lead to off-tracking of the guidewire outside the vein. [ 6 ] These complications are more common with inexperienced operators, increasing number of attempts, severe dehydration (reduced diameter of the vein), and morbid obesity.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein

Bajaj¹,

Khan²

2021

J Med Ultrasound

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Hemodialysis catheters are commonly placed in the major central vein for the purpose of dialysis. Coiling or looping of guidewire is a rare but reported complication of a central vascular catheter insertion. We report a case in which we encountered a rare complication of looping of the guidewire used for dialysis catheter placement and how we correctly diagnosed and repositioned it under ultrasound guidance. A 68-yearold man diagnosed with Carcinoma of Pyriform Fossa admitted in our ICU had Acute Renal Failure. An attempt to insertion of hemodialysis catheter in left internal jugular vein was made. Following successful puncture, the guide wire was threaded through needle. After five centimeter length of guide wire was threaded, resistance was felt and a loop of guidewire was visualized which was abutting the posterior wall of vein in out-of-plane view, creating a dual-point echogenicity. Under ultrasound guidance, we slowly pulled out the guidewire till the loop disappeared.The catheter was then inserted without repeat puncture of the vessel, thus preventing chance of thrombosis by repeated attempts. Real time USG guidance not only improves the success rates but also decreases the number of attempts and complications related to hemodialysis catheterization. Moreover, it benefits the patients by reducing the risks and discomforts of the procedure by reducing the duration of cannulation. The intelligent use of real-time ultrasound guidance in each step of the central venous catheterization is absolutely the need of the hour to prevent catastrophic yet preventable complications.

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Section: Discussionmentioning

confidence: 99%

Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein

Bajaj¹,

Khan²

2021

J Med Ultrasound

View full text Add to dashboard Cite

show abstract

“…We believe that the insertion of tissue dilator at a more vertical angle than the guide wire was the triggering event in this case. Considerable force can be inadvertently applied during this step which can lead to not only kinking but also unraveling of the guide wire,[ 4 ] leading to serious consequences. However, this force is not sufficient enough to produce the bend in the dilator as described.…”

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confidence: 99%