Extract:
“A 50-year-old male got admitted in the ICU as a postoperative case of right temporoparietal subdural hematoma. Central venous cannulation was planned for prolonged intravenous access. Under aseptic conditions, right IJV was cannulated with an introducer needle by an experienced resident doctor. Following this, the guide-wire was introduced without any resistance. Then the catheter was railroaded over the guide-wire but while checking for backflow through the catheter, the doctor noticed that the proximal end of the guide-wire was not visible through the catheter. Immediately, a bedside chest X-ray was obtained which showed the proximal end of the guide-wire out of the distal end of the catheter and it was traversing through superior vena cava (SVC), right atrium and inferior vena cava (IVC) [Figure 1]. Although the patient’s vitals remained stable during this period, the patient was immediately shifted to the Cath lab for removal of the guide-wire. During fluoroscopy, the guide-wire was found to be traveled further down there into lower IVC with distal end in right iliac vein above the femoral head [Figure 2]. Then the guide-wire was retrieved with a goose neck snare by placing 8 French catheters in venous sheath of right femoral vein without any complications.”
Reference:Deep G, Sidhu N, Gupta KK, Sharma R. Loss of guide-wire during central venous cannulation – Life long learning! J Anaesthesiol Clin Pharmacol. 2022 Jan-Mar;38(1):156-157. doi: 10.4103/joacp.JOACP_20_19. Epub 2022 Apr 25. PMID: 35706621; PMCID: PMC9191816.