The forgotten guide wire: a rare complication of hemodialysis catheter insertion

Area of Science:

• Nephrology
• Vascular Surgery
• Interventional Radiology

Background:

• Hemodialysis catheter insertion is a common procedure for patients with end-stage renal disease.
• Guide wire loss into circulation is a rare but serious complication.
• Systemic lupus erythematosus (SLE) patients may have unique challenges during vascular access procedures.

Observation:

• A 19-year-old female with SLE experienced guide wire loss into circulation during right femoral vein hemodialysis catheter insertion.
• The patient remained asymptomatic for 2 days, undergoing two plasmapheresis treatments.
• The lost guide wire was successfully retrieved without immediate complications.

Findings:

• Complete guide wire loss into circulation can be asymptomatic.
• Delayed recognition of guide wire retention is possible.
• Successful retrieval of retained guide wires is achievable.

Implications:

• Highlights the importance of meticulous technique and vigilance during guide wire use in catheterization.
• Underscores the need for standardized protocols to prevent guide wire retention.
• Suggests that asymptomatic patients with retained guide wires may still benefit from retrieval to avoid potential long-term risks.