J-tip guide wire entrapment within the heart during central venous catheterization

Area of Science:

• Cardiology
• Nephrology
• Interventional Radiology

Background:

• Hemodialysis catheter placement is a common procedure for patients with end-stage renal disease.
• Complications, though rare, can arise during central venous catheter insertion.

Observation:

• A 55-year-old female developed ventricular premature rhythms during hemodialysis catheter insertion.
• Fluoroscopy revealed guide wire knotting within the right ventricle.

Findings:

• The J-tip guide wire became entrapped in the right ventricle, preventing its removal.
• Successful retrieval of the guide wire was achieved using a guiding catheter.

Implications:

• This case highlights the potential for guide wire entrapment during central venous catheterization.
• Real-time fluoroscopic and electrocardiographic monitoring are essential to prevent and manage such complications.
• Consideration of straight or curved guide wires may reduce the risk of knotting.