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Rare complications of micropuncture vascular access in the ICU
Kentaro Okamoto1, Chase Donaldson1, Dale Marsh1
1Intensive Care and Resuscitation, Cleveland Clinic Main Campus Hospital, Cleveland, OH, USA.
Abstract:
Micropuncture vascular access is increasingly being used in the intensive care unit (ICU) due to its perceived reduction of bleeding complications in common ICU procedures. The authors report two rare complications associated with micropuncture kit use associated with vascular access. The first case involved a fracture of the micropuncture wire with a remnant retained in the blood vessel. The second case involved the formation of a knot within the flexible tip of the micropuncture wire in the subcutaneous tissue. The unique design of the flexible tipped 0.018-inch guide wire may be prone to unique complications for which an understanding of the proper technique for its use is necessary to prevent these complications.
Insights
Micropuncture vascular access, common in intensive care units (ICUs), can lead to rare wire fractures and knotting complications. Proper technique is crucial to prevent these issues.
Area of Science:
- Vascular Surgery
- Intensive Care Medicine
- Medical Device Technology
Background:
- Micropuncture vascular access is frequently employed in intensive care units (ICUs).
- It is perceived to reduce bleeding complications in common ICU procedures.
- However, rare complications associated with its use have been reported.
Purpose of the Study:
- To report two rare complications associated with micropuncture kit use in vascular access.
- To highlight potential risks and the importance of proper technique.
Main Methods:
- Case report of two distinct complications during micropuncture vascular access procedures.
- Analysis of the micropuncture wire's unique design and potential failure modes.
Main Results:
- Case 1: Fracture of the micropuncture wire with a retained fragment in the blood vessel.
- Case 2: Formation of a knot within the flexible tip of the micropuncture wire in subcutaneous tissue.
Conclusions:
- The unique design of the 0.018-inch flexible-tipped micropuncture wire may predispose to specific complications.
- A thorough understanding and application of proper technique are necessary to mitigate these risks and ensure patient safety.
