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Related Concept Videos

Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Cardiac Catheterization III: Left Heart Catheterization01:24

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Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
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Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
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Cardiac Catheterization I: Pre-Procedure Overview01:28

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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Related Experiment Video

Updated: Nov 17, 2025

The Supraclavicular Fossa Ultrasound View for Central Venous Catheter Placement and Catheter Change Over Guidewire
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Guidewire knot formation with peripherally inserted central catheter.

Hiroaki Saito1, Tsuyoshi Suda1, Yoji Nishida2

  • 1Department of Internal Medicine Kanazawa Municipal Hospital Kanazawa Japan.

Clinical Case Reports
|February 18, 2021
PubMed
Summary

Guidewire knot formation during peripherally inserted central catheter (PICC) insertion is a rare but serious complication. Forced manipulation of a knotted guidewire risks vein tearing, necessitating surgical removal to prevent vascular injury.

Keywords:
Vascular surgerycardiovascular disorders

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Medical Device Complications

Background:

  • Peripherally inserted central catheters (PICCs) are widely used for long-term venous access.
  • Guidewire manipulation is a critical step during PICC insertion.
  • Complications, though rare, can arise from guidewire use.

Purpose of the Study:

  • To highlight the extreme rarity and potential severity of guidewire knot formation during PICC insertion.
  • To emphasize the risks associated with manipulating a knotted guidewire.
  • To underscore the necessity of surgical intervention in such cases.

Main Methods:

  • Case review of PICC insertion procedures.
  • Analysis of complication reports.
  • Review of interventional techniques for guidewire removal.

Main Results:

  • Guidewire knot formation during PICC insertion is an exceptionally rare event.
  • Forced insertion or withdrawal of a knotted guidewire can lead to significant venous tearing.
  • Surgical guidewire removal is often required to mitigate risks of vascular injury.

Conclusions:

  • Guidewire knotting is a critical, albeit infrequent, complication of PICC insertion.
  • Vigilance and appropriate management are essential to prevent iatrogenic vascular trauma.
  • Prompt surgical intervention may be necessary for safe removal and patient safety.