Knot formation of a guidewire during subclavian venous catheterization: A case report
Central venous catheters are used for a variety of purposes, including emergency care, parenteral nutrition, and chemotherapy, but their insertion can cause mechanical complications such as malposition, arterial puncture, and pneumothorax. Here, we describe a rare case of guidewire knot formation du...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Radiology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S193004332200615X |
| _version_ | 1817998669473906688 |
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| author | Kotaro Sekiguchi, MD Hideyuki Takano, MD |
| author_facet | Kotaro Sekiguchi, MD Hideyuki Takano, MD |
| author_sort | Kotaro Sekiguchi, MD |
| collection | DOAJ |
| description | Central venous catheters are used for a variety of purposes, including emergency care, parenteral nutrition, and chemotherapy, but their insertion can cause mechanical complications such as malposition, arterial puncture, and pneumothorax. Here, we describe a rare case of guidewire knot formation during subclavian vein catheterization. A 70-year-old woman presented to our facility for central venous port placement for chemotherapy after surgical resection of a retroperitoneal liposarcoma. The left subclavian vein was selected and punctured under ultrasound guidance, and a guidewire was introduced. However, strong resistance prevented both advancement and withdrawal of the guidewire. Radiograph revealed a knot like shadow near the tip of the guidewire. After placement of a central venous port in the opposite site, the knotted guidewire was surgically removed. Intraoperatively, the guidewire was found to penetrate the vein and form a knot on the outside of the posterior wall. Although the guidewire was able to be removed, a postoperative chest x-ray revealed a left pneumothorax, which required 10 days of treatment. If a knot forms in a guidewire during catheterization, surgical removal is recommended because forcible pulling can damage the vessel. In conclusion, guidewire knot formation is a very rare complication, but physicians performing central venous catheterization should be aware of it, and this report describes how to prevent and manage it. |
| first_indexed | 2024-04-14T02:56:25Z |
| format | Article |
| id | doaj.art-f0d481d7d55643f7a733d39e0d53545f |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-04-14T02:56:25Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-f0d481d7d55643f7a733d39e0d53545f2022-12-22T02:16:05ZengElsevierRadiology Case Reports1930-04332022-10-01171039233926Knot formation of a guidewire during subclavian venous catheterization: A case reportKotaro Sekiguchi, MD0Hideyuki Takano, MD1Corresponding author.; Department of Radiology, Chiba Cancer Center, 666-1, Chuo-Ku, Chiba, Chiba, JapanDepartment of Radiology, Chiba Cancer Center, 666-1, Chuo-Ku, Chiba, Chiba, JapanCentral venous catheters are used for a variety of purposes, including emergency care, parenteral nutrition, and chemotherapy, but their insertion can cause mechanical complications such as malposition, arterial puncture, and pneumothorax. Here, we describe a rare case of guidewire knot formation during subclavian vein catheterization. A 70-year-old woman presented to our facility for central venous port placement for chemotherapy after surgical resection of a retroperitoneal liposarcoma. The left subclavian vein was selected and punctured under ultrasound guidance, and a guidewire was introduced. However, strong resistance prevented both advancement and withdrawal of the guidewire. Radiograph revealed a knot like shadow near the tip of the guidewire. After placement of a central venous port in the opposite site, the knotted guidewire was surgically removed. Intraoperatively, the guidewire was found to penetrate the vein and form a knot on the outside of the posterior wall. Although the guidewire was able to be removed, a postoperative chest x-ray revealed a left pneumothorax, which required 10 days of treatment. If a knot forms in a guidewire during catheterization, surgical removal is recommended because forcible pulling can damage the vessel. In conclusion, guidewire knot formation is a very rare complication, but physicians performing central venous catheterization should be aware of it, and this report describes how to prevent and manage it.http://www.sciencedirect.com/science/article/pii/S193004332200615XCentral venous catheterComplicationsGuidewireKnot |
| spellingShingle | Kotaro Sekiguchi, MD Hideyuki Takano, MD Knot formation of a guidewire during subclavian venous catheterization: A case report Radiology Case Reports Central venous catheter Complications Guidewire Knot |
| title | Knot formation of a guidewire during subclavian venous catheterization: A case report |
| title_full | Knot formation of a guidewire during subclavian venous catheterization: A case report |
| title_fullStr | Knot formation of a guidewire during subclavian venous catheterization: A case report |
| title_full_unstemmed | Knot formation of a guidewire during subclavian venous catheterization: A case report |
| title_short | Knot formation of a guidewire during subclavian venous catheterization: A case report |
| title_sort | knot formation of a guidewire during subclavian venous catheterization a case report |
| topic | Central venous catheter Complications Guidewire Knot |
| url | http://www.sciencedirect.com/science/article/pii/S193004332200615X |
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