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Retained Jugular Guidewire

big hi to all members,

have a look at the images. this happened when a central venous line was being inserted via the right IJV. for all those who want to know, no... i didnt do it... :) an overenthusiastic but probably weary resident forgot to remove the guidewire after puncturing the vein and inadvertently pushed it deep inside. guidewire course is from IJV to SVC to RA to SVC to SUBLAVIAN V to AXILLARY v. the result....

please post ur comments and related images so we can all learn....

Tags: cannulation, complication, guidewire, iatrogenic, jugular

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IMAG0483.jpg, 91 KB
IMAG0487.jpg, 89 KB

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Permalink Reply by Subrahmanyam Karuturi on September 23, 2010 at 11:00am

That's an interesting thing to happen on a night call. How did you remove the guide wire?

I would like to point to two related journal articles.

1. Loss of the guide wire: mishap or blunder?
Br. J. Anaesth. (2002) 88 (1): 144-146. doi: 10.1093/bja/88.1.144

2. Unsuspected retained 60-cm intravenous guidewire
Conrad D. Cassie, Michelle S. Ginsberg, David M. Panicek
Clinical Imaging - July 2006 (Vol. 30, Issue 4, Pages 287-290, DOI: 10.1016/j.clinimag.2005.12.024)

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Permalink Reply by NIKHIL CHOUDHARY on October 1, 2010 at 12:58pm

thanks subramaniam, very informative articles attached...

we inserted a snare through the femoral route and hooked the guidewire from the jugular vein. the wire was snared and pulled out thereafter. the patient is doing great.