Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein
Hemodialysis catheters are commonly placed in the major central vein for the purpose of dialysis. Coiling or looping of guidewire is a rare but reported complication of a central vascular catheter insertion. We report a case in which we encountered a rare complication of looping of the guidewire use...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Medical Ultrasound |
| Subjects: | |
| Online Access: | http://www.jmuonline.org/article.asp?issn=0929-6441;year=2021;volume=29;issue=3;spage=209;epage=211;aulast=Bajaj |
| _version_ | 1818834883434250240 |
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| author | Jhanvi Bajaj Mohammed Saif Khan |
| author_facet | Jhanvi Bajaj Mohammed Saif Khan |
| author_sort | Jhanvi Bajaj |
| collection | DOAJ |
| description | Hemodialysis catheters are commonly placed in the major central vein for the purpose of dialysis. Coiling or looping of guidewire is a rare but reported complication of a central vascular catheter insertion. We report a case in which we encountered a rare complication of looping of the guidewire used for dialysis catheter placement and how we correctly diagnosed and repositioned it under ultrasound guidance. A 68-year-old man diagnosed with Carcinoma of Pyriform Fossa admitted in our ICU had Acute Renal Failure. An attempt to insertion of hemodialysis catheter in left internal jugular vein was made. Following successful puncture, the guide wire was threaded through needle. After five centimeter length of guide wire was threaded, resistance was felt and a loop of guidewire was visualized which was abutting the posterior wall of vein in out-of-plane view, creating a dual-point echogenicity. Under ultrasound guidance, we slowly pulled out the guidewire till the loop disappeared. The catheter was then inserted without repeat puncture of the vessel, thus preventing chance of thrombosis by repeated attempts. Real time USG guidance not only improves the success rates but also decreases the number of attempts and complications related to hemodialysis catheterization. Moreover, it benefits the patients by reducing the risks and discomforts of the procedure by reducing the duration of cannulation. The intelligent use of real-time ultrasound guidance in each step of the central venous catheterization is absolutely the need of the hour to prevent catastrophic yet preventable complications. |
| first_indexed | 2024-12-19T02:41:54Z |
| format | Article |
| id | doaj.art-cd2ca24244354b8c9a906cd3929bec94 |
| institution | Directory Open Access Journal |
| issn | 0929-6441 2212-1552 |
| language | English |
| last_indexed | 2024-12-19T02:41:54Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Medical Ultrasound |
| spelling | doaj.art-cd2ca24244354b8c9a906cd3929bec942022-12-21T20:39:07ZengWolters Kluwer Medknow PublicationsJournal of Medical Ultrasound0929-64412212-15522021-01-0129320921110.4103/JMU.JMU_99_20Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular veinJhanvi BajajMohammed Saif KhanHemodialysis catheters are commonly placed in the major central vein for the purpose of dialysis. Coiling or looping of guidewire is a rare but reported complication of a central vascular catheter insertion. We report a case in which we encountered a rare complication of looping of the guidewire used for dialysis catheter placement and how we correctly diagnosed and repositioned it under ultrasound guidance. A 68-year-old man diagnosed with Carcinoma of Pyriform Fossa admitted in our ICU had Acute Renal Failure. An attempt to insertion of hemodialysis catheter in left internal jugular vein was made. Following successful puncture, the guide wire was threaded through needle. After five centimeter length of guide wire was threaded, resistance was felt and a loop of guidewire was visualized which was abutting the posterior wall of vein in out-of-plane view, creating a dual-point echogenicity. Under ultrasound guidance, we slowly pulled out the guidewire till the loop disappeared. The catheter was then inserted without repeat puncture of the vessel, thus preventing chance of thrombosis by repeated attempts. Real time USG guidance not only improves the success rates but also decreases the number of attempts and complications related to hemodialysis catheterization. Moreover, it benefits the patients by reducing the risks and discomforts of the procedure by reducing the duration of cannulation. The intelligent use of real-time ultrasound guidance in each step of the central venous catheterization is absolutely the need of the hour to prevent catastrophic yet preventable complications.http://www.jmuonline.org/article.asp?issn=0929-6441;year=2021;volume=29;issue=3;spage=209;epage=211;aulast=Bajajcentral venous catheterizationguidewirehemodialysisrescueultrasound |
| spellingShingle | Jhanvi Bajaj Mohammed Saif Khan Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein Journal of Medical Ultrasound central venous catheterization guidewire hemodialysis rescue ultrasound |
| title | Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein |
| title_full | Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein |
| title_fullStr | Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein |
| title_full_unstemmed | Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein |
| title_short | Ultrasound to the rescue: Management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein |
| title_sort | ultrasound to the rescue management of looped guidewire during hemodialysis catheter insertion in the left internal jugular vein |
| topic | central venous catheterization guidewire hemodialysis rescue ultrasound |
| url | http://www.jmuonline.org/article.asp?issn=0929-6441;year=2021;volume=29;issue=3;spage=209;epage=211;aulast=Bajaj |
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