The dos and do knots of central venous catheterization

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Updated: May 24, 2026

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
09:57

A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit

Published on: July 13, 2019

Luigi Vetrugno1, Gianluca Piccoli, Maria Gabriella Costa

  • 1Department of Anesthesia and Intensive Care Medicine, University of Udine, 33100 Udine, Italy. vetrugnoluigi@katamail.com

Journal of Clinical Anesthesia
|March 15, 2012
PubMed

Insights

Guidewire complications during central venous catheterization for hemodialysis can be resolved with advanced imaging. Computed tomographic and 3D scans accurately located the misplaced guidewire, ensuring patient safety.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Radiology

Background:

  • Central venous catheterization is crucial for end-stage renal disease (ESRD) patients requiring hemodialysis.
  • Right subclavian catheter placement is a common procedure for vascular access in hemodialysis.

Observation:

  • A complication occurred during right subclavian hemodialysis catheter insertion, involving guidewire looping and entrapment.
  • The guidewire was found to be outside the intended vascular lumen.

Findings:

  • Computed tomography (CT) and three-dimensional (3D) imaging were instrumental in diagnosing the complication.
  • These advanced imaging techniques precisely located the malpositioned guidewire, confirming it was extravascular.

Implications:

  • CT and 3D scans are essential tools for managing guidewire complications during central venous catheterization.
  • Accurate imaging ensures timely intervention and prevents potential patient injury, improving hemodialysis access outcomes.

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The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire07:47

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