Minimal Symptoms From a 7-Month Retained Guidewire Following Acute Non-Tunneled Hemodialysis Catheter Insertion: A...

Central venous catheterization (CVC), commonly used for hemodialysis due to its rapid access and immediate utility, carries risks-including the rare complication of guidewire retention. While typically identified early, retained guidewires can occasionally go unnoticed and migrate, leading to delayed and unexpected symptoms. This case report describes an unusual instance where a retained guidewire, undetected for 7 months, presented as thigh swelling. The case highlights the importance of sustained clinical vigilance, even long after routine procedures. A 52-year-old man with early-stage chronic kidney disease (CKD) underwent emergency hemodialysis via a non-tunneled jugular catheter. Seven months later, he developed localized swelling near the right knee. Imaging revealed a fractured guidewire extending from the inferior vena cava (IVC) to the femoral vein. Before the scheduled surgical intervention, the guidewire spontaneously protruded through the skin and was self-extracted by the patient. Follow-up imaging showed two small residual fragments, but with symptom resolution, conservative management was chosen. At 6-month follow-up, the patient remained asymptomatic.