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Complete guidewire retention after femoral vein catheterization
Bahar Gulcay Cat, Sertac Guler1, Murat Soyuduru
1Sertaç Guler, MD Department of Emergency Medicine, Ankara Training and Research Hospital, Ankara, Turkey T: +90 532 554 83 88 drsertacguler@gmail.com.
Insights
A rare complication of central venous catheter (CVC) insertion, retained guidewire, was diagnosed 6 months after femoral vein catheterization. This case highlights the possibility of asymptomatic, long-term guidewire retention in the femoral vein.
Area of Science:
- Vascular Surgery
- Emergency Medicine
- Radiology
Background:
- Central venous catheters (CVCs) are essential tools in emergency departments (EDs) for procedures like hemodialysis and hemodynamic monitoring.
- Complications from CVC insertion are typically mechanical and occur shortly after the procedure.
Observation:
- A rare case of complete retained guidewire following left femoral vein catheterization 6 months prior was diagnosed in the ED.
- This represents the first reported instance of a retained CVC guidewire with retrograde migration into the femoral vein.
Findings:
- Despite a 6-month duration of guidewire retention within the femoral vein, the patient experienced no thrombotic or embolic complications.
- The diagnosis was made 6 months after the initial catheterization in an intensive care unit at a different hospital.
Implications:
- This case underscores the importance of considering delayed complications of CVC insertion, even in asymptomatic patients.
- It suggests that long-term, asymptomatic retention of guidewires in the femoral vein may be possible, challenging previous assumptions about immediate complication risks.
Abstract:
Central venous catheters (CVCs) are often used for various purposes in the emergency departments (ED). The main uses of CVCs in the EDs are emergent hemodialysis, in situations where peripheral vein catheterization cannot be achieved, and continuous invasive hemodynamic monitoring. The complications related to CVC insertion are usually mechanical and observed in the near term after the procedure. Retained CVC guidewire after catheterization is a rare complication in the published reports and usually related with intra- or postoperative settings and jugular or subclavian vein. The present study reported a young female patient who underwent left femoral vein catheterization 6 months earlier in an intensive care unit of another hospital and was diagnosed with complete guidewire retention in the ED. To the best of the authors' knowledge, this is the first case in published reports with a diagnosis of retained CVC guidewire with retrograde migration into the femoral vein. Surprisingly, the patient developed no thrombotic or embolic complication during this 6-month period.
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