Forgotten guidewire: A case report

Diniz, Paulo; Rodriguez, Juan Eduardo Rios; Oliveira, João Pedro Salgado Pio; Lira, Mirella Cruz; Rocha, Renan Danilo Lima da; Campelo, Priscilla Ribeiro dos Santos; Matos, Juliana da Costa; Cavalcante, Leonardo Pessoa

doi:10.1016/j.amsu.2022.103867

Cited by 2 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This event occurred 3 weeks later, which is considered an early complication needing immediate intervention, unlike our case, in which the complication took years to develop. Nevertheless, the guidewire was removed by laparotomy after a failed trial of snaring technique, similar to our case, which also required surgical intervention for removal [ 4 ].…”

Section: Discussionmentioning

confidence: 92%

“…As we mentioned earlier, our patient presented 4 years after insertion of a CVC in an ICU. This is considered a long time, and removal of the wire was practically difficult to remove and manage, as missed guidewires can usually be detected immediately after insertion by routine radiography [ 4 ]; indeed, most patients with missed guidewire presented much earlier than did our patient. There are few cases documented in the literature with a similar timeline [ 2 , 7 ].…”

Section: Discussionmentioning

confidence: 93%

“…Multiple factors can lead to the loss of a guidewire, such as disturbing the physician while inserting the CVC, physicians’ hand skills and expertise, work overburden, and absence of supervisor’s guidance and care for trainees, which is the most reported risk factor in the literature [ 4 ]. In the present case, we do not have an idea of how the guidewire had gone unnoticed for 4 years, as the procedure was done overseas.…”

Section: Discussionmentioning

confidence: 99%

“…The Seldinger technique is the most common method of inserting a CVC. It requires a metallic guidewire to be introduced into the lumen of a venipuncture needle, which provides a track for sliding the CVC [ 4 ]. There are many potential complications associated with CVC insertion, such as failure to place the catheter (22%), arterial puncture (5%), catheter malposition (4%), pneumothorax (1%), subcutaneous hematoma (1%), hemothorax (less than 1%), and cardiac arrest (less than 1%) [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

A 47-Year-Old Woman with a Retained Central Venous Catheter Line Guidewire Presenting with a Right Atrial Thrombus Requiring Removal During Open Heart Surgery: A Case Report

Alsaka Amini,

Alzuabi,

Baniyaseen

et al. 2023

Am J Case Rep

View full text Add to dashboard Cite

Patient: Female, 47-year-old Final Diagnosis: Right atrial mass due to missed central venous catheter guidewire Symptoms: Shortness of breath Clinical Procedure: Open heart surgery Specialty: Anesthesiology • Cardiac Surgery • Cardiology • Critical Care Medicine Objective: Rare coexistence of disease or pathology Background: A central venous catheter (CVC) is an indwelling catheter that is inserted into a large central vein for different purposes, including hemodynamic monitoring and administration of fluids and medications. This report is of a 47-year-old woman with a retained CVC line guidewire presenting with a large right atrial thrombus requiring removal during open heart surgery. CVC insertion is one of the most frequently attempted procedures in intensive care units, emergency departments, and operation rooms, especially for critically ill patients. Possible complications range from failure to place the catheter to cardiac arrest. One of the rarest complications is missing the guidewire after insertion, which is usually discovered early after inserting it. Case Report: We report the case of a 47-year-old woman who had a CVC line inserted following complicated open cholecystectomy. A few years later, she developed shortness of breath, with an incidental finding of a huge right atrial thrombus and a wire shown on transthoracic echocardiography. The right atrial thrombus required open heart surgery to excise the thrombus and the wire, which was done successfully. The thrombus was histopathologically and clinically proven to be an organized right atrial thrombus formed around the CVC guidewire. Conclusions: This case report presents a rare complication of CVC insertion. Because this procedure is increasingly used, clinicians should be aware of the potential complications of retained CVC lines. Moreover, this report outlines different techniques to prevent such fatal complications and emphasizes the significance of radiography after insertion.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A 47-Year-Old Woman with a Retained Central Venous Catheter Line Guidewire Presenting with a Right Atrial Thrombus Requiring Removal During Open Heart Surgery: A Case Report

Alsaka Amini,

Alzuabi,

Baniyaseen

et al. 2023

Am J Case Rep

View full text Add to dashboard Cite

show abstract

“…Guidewire loss often occurs due to operator error and remains undisclosed due to fear and concerns about the consequences, and is usually discovered accidentally after a long time (4) or after the development of related complications. Complications of guide wire loss include the migration of the guide wire to the pulmonary artery (5), guidewire knocking (6), a broken guidewire (7), arteriovenous fistula (8), and cerebral stroke (9). The guidewire can migrate to different places, such as from femoral to jugular (10), or infection and endocarditis (the presented case) (11,12).…”

Section: Introductionmentioning

confidence: 99%

Should a forgotten guidewire be removed after years? An undesirable complication of hemodialysis catheter wire left in the body

Hekmat,

Ghaderi,

Ansari Aval

et al. 2023

J Nephropharmacol

View full text Add to dashboard Cite

Today, one of the most common methods used in the emergency room or intensive care unit (ICU) in patients is the Seldinger technique to access the central venous system, shunting for hemodialysis, intra-aortic balloon pump, or arterial insertion. Accidental leaving of the guide wire is an uncommon but important complication that can occur as a result of an incorrect technique, and it is sometimes found accidentally or due to complications years after the procedure. The case is a 53-year-old patient who underwent aortic valve replacement with a mechanical valve and mitral valve repair with a ring 12 years ago and was treated with warfarin. Two years after the heart surgery, due to chronic renal failure, the patient underwent dialysis, and after the preparation of an arteriovenous fistula, he underwent stenting. After approximately ten years, the patient developed fever, chills, and shortness of breath. During the examination, endocarditis was diagnosed, and a part of the aortic valve was released. There was a severe paravalvular leak in the aortic valve, and an abscess was formed in the aorta root. We also noticed a forgotten guide wire in the superior vena cava, right atrium, inferior vena cava, and hepatic vein, and echogenic masses were located on the guidewire. The diagnosis was confirmed by echocardiography, chest x-ray, and phenocopy. After antibiotic therapy, the patients underwent heart surgery, aortic valve replacement, and aortic root repair, and the guidewire was removed (70 cm long). Unfortunately, despite all measures, the patient died a few days after the surgery. Due to complications, a forgotten guidewire should be removed immediately after diagnosis. The preferred intervention is the removal of the guidewire by endovascular interventions, but surgical treatment should also be considered in some cases.

show abstract

Forgotten guidewire: A case report

Cited by 2 publications

References 12 publications

A 47-Year-Old Woman with a Retained Central Venous Catheter Line Guidewire Presenting with a Right Atrial Thrombus Requiring Removal During Open Heart Surgery: A Case Report

A 47-Year-Old Woman with a Retained Central Venous Catheter Line Guidewire Presenting with a Right Atrial Thrombus Requiring Removal During Open Heart Surgery: A Case Report

Should a forgotten guidewire be removed after years? An undesirable complication of hemodialysis catheter wire left in the body

Contact Info

Product

Resources

About