Unrecognised guide wire migration during internal jugular cannulation and its retrieval--a case report

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Critical Care Medicine

Background:

• Central venous catheter (CVC) insertion is a common procedure in critical care.
• Guide wire loss is a rare but serious complication during CVC placement.
• Prompt recognition and retrieval are crucial to prevent patient harm.

Observation:

• A 40-year-old female developed a retained guide wire after right internal jugular cannulation for resuscitation.
• The lost guide wire was incidentally diagnosed two months post-procedure via thoraco-abdominal CT scan.
• The guide wire traversed the superior vena cava, right atrium, inferior vena cava, and terminated in the right femoral vein.

Findings:

• Computed tomography (CT) imaging identified the intravascular metallic foreign body.
• Successful retrieval of the guide wire was achieved through right femoral venotomy under local anesthesia.
• The case highlights the importance of vigilance in CVC procedures.

Implications:

• This case underscores the potential for delayed diagnosis of retained intravascular foreign bodies.
• Adherence to precautionary measures during CVC insertion can prevent guide wire loss.
• Effective management strategies are essential for rare complications of central venous access.