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Updated: Dec 13, 2025

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
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Aberrant Trajectory Of A Central Venous Catheter

Jânia Pacheco1, Marta Coelho1, Maria Alexandra Almeida Resende1

  • 1Centro Hospitalar Universitário de Lisboa Norte, Serviço de Anestesiologia, Portugal.

Revista Portuguesa De Cirurgia Cardio-Toracica E Vascular : Orgao Oficial Da Sociedade Portuguesa De Cirurgia Cardio-Toracica E Vascular
|July 25, 2020
PubMed

Insights

A guidewire lodged in the right subclavian vein during central venous catheter placement required urgent surgical removal. Angio-CT identified the aberrant path, leading to a mini-sternotomy for safe extraction.

Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Device Complications

Background:

  • Central venous catheterization is a common procedure.
  • Guidewire complications, though rare, can pose significant risks.
  • Aberrant guidewire placement necessitates prompt diagnosis and intervention.

Purpose of the Study:

  • To report a rare case of an unextractable guidewire during central venous catheterization.
  • To highlight the utility of Angio-Computed Tomography in diagnosing guidewire malposition.
  • To describe the successful surgical management of this complication.

Main Methods:

  • A case report detailing the event during central venous catheter insertion.
  • Diagnostic imaging using Angio-Computed Tomography to visualize guidewire trajectory.
  • Surgical intervention via mini-sternotomy for guidewire and catheter retrieval.

Main Results:

  • Inability to retrieve the guidewire after central venous catheter placement.
  • Angio-Computed Tomography revealed an aberrant guidewire path.
  • Successful extraction of the guidewire and catheter through mini-sternotomy.

Conclusions:

  • Aberrant guidewire migration is a serious complication of central venous catheterization.
  • Advanced imaging like Angio-CT is crucial for identifying malpositioned guidewires.
  • Surgical intervention may be required for the safe removal of retained guidewires.

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