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Reminder of important clinical lesson
CASE REPORT
Stuck guidewire due to soft tissue imposition: a rare complication of central line catheter placement
  1. Niraj Kumar1,
  2. Saurav Burman1,
  3. Anuradha Yadav2,
  4. Gaurav Singh Tomar1
  1. 1Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India
  2. 2Oral Medicine and Radiology, All India Institute of Medical Sciences, New Delhi, Delhi, India
  1. Correspondence to Dr Niraj Kumar, drnirajaiims{at}gmail.com

Summary

Central venous catheter (CVC) placement is a commonly done procedure but is associated with a few complications, and guidewire-related complications are one of them. In our case after induction of general anaesthesia, we planned to insert a CVC in the right internal jugular vein under ultrasound guidance. After the insertion of the introducer needle, when we tried to insert the guidewire, it got stuck and was neither moving forward nor in a backward direction. Too much force was not applied to remove the guidewire as it might have caused shearing of the guidewire and further complicated the picture. This problem was solved by simultaneous withdrawal of guidewire along with the needle, and on examination we found soft tissue debris lodged within the lumen which was preventing the guidewire movement in both directions. So, it is suggested that guidewire should be removed along with needle as a single unit if it is required.

  • anaesthesia
  • intensive care
  • neuroanaesthesia

https://doi.org/10.1136/bcr-2018-224219

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    Footnotes

    • Contributors NK (corresponding author): conception and design, acquisition of data, interpretation of data, revising it critically for important intellectual content, drafting the article. SB: conception and design, acquisition of data. AY: interpretation of data, drafting the article. GST: final approval of the version, revising it critically for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.