Accidental guide wire migration and late percutaneous externalization after central venous catheterization

J Vasc Access. 2023 Jul;24(4):824-827. doi: 10.1177/11297298211054898. Epub 2021 Oct 28.

Abstract

A 70-year-old man was admitted to the emergency department with recent spontaneous externalization of a metallic device from his right inner thigh. He had been experiencing mild local pain for 2 weeks and had a recent hospitalization due to cardiogenic hemodynamic instability, requiring a central venous catheter placement in his right internal jugular vein 3 months earlier. Doppler ultrasound confirmed the intravascular foreign body hypothesis as a guidewire was identified inside the right femoral vein, associated with femoropopliteal venous thrombosis. The guidewire was successfully removed percutaneously through simple manual traction guided by radioscopy. The patient was discharged the following day on oral anticoagulation with rivaroxaban. On outpatient follow-up 4 weeks post discharge, he had no complaints in the right lower limb except for slight swelling. Central venous catheterization is a common invasive procedure that, although unquestionably safe and well stablished in medical practice, can lead to serious complications when performed without proper technique.

Keywords: Central venous catheter; Seldinger technique; emergency; medical procedure complications; thrombosis.

Publication types

  • Case Reports

MeSH terms

  • Aftercare
  • Aged
  • Brachiocephalic Veins
  • Catheterization, Central Venous*
  • Central Venous Catheters*
  • Foreign Bodies*
  • Humans
  • Jugular Veins / diagnostic imaging
  • Male
  • Patient Discharge