During insertion of the central venous catheter, there was difficulty in advancing the guidewire. Attempts were made to remove the guidewire through the introducer, but the guidewire would not thread out of the introducer” Tirumala et al (2018).
Introduction: Central venous catheters are essential and widely used in medical practice. Their use may be accompanied with complications during insertion and removal. Complications related to the guidewire are rare, and information about appropriate management is scarce. We report a case of a 34-year-old patient admitted for a left femur fracture. The patient was a difficult access, so decision was made to place a central venous catheter before surgery. During insertion of the central venous catheter, there was difficulty in advancing the guidewire. Attempts were made to remove the guidewire through the introducer, but the guidewire would not thread out of the introducer. The introducer and guidewire were then removed as a unit with ease. The guidewire had lost its shape and uncoiled itself, becoming much more flimsy and fragile.
Conclusion: While this case had no adverse outcome secondary to the removal of the guidewire and introducer as a unit, careful attention should be noted when attempting to remove the guidewire during central venous catheter placement. If faced with a similar scenario where the guidewire is stuck and does not thread out easily, removing the guidewire and introducer as a unit is a safe method of action.
Tirumala, S., Hyatali, F., Eskander, J., Leandre, M., Patil, S. and Cornette, E. (2018) Unexpected complications during insertion of a central venous catheter. Journal of Perioperative Practice. January 1st. .