A Case Report: Surgical Removal of Missing Guide Wire, Is it the Best Intervention?

Abstract

Nowadays, the use of central venous catheter insertion (CVC), has abundantly increased. It is a common technique in critically ill patients who are admitted to intensive care and emergency departments in order to hemodynamic monitoring and fluid and medication administration. In this report, we express a 28-year-old man who has multiple trauma with decreased level of consciousness during a car accident three months ago and needs intensive care and monitoring by central venous catheter placing. A missed guide wire remaining inside the venous system after peripherally inserted in femoral vein that was incidentally diagnosed by taking a chest X-ray after three months. Although, guide wires are often retrieved by snaring catheter under fluoroscopic guidance and an interventional cardiologist, we have successfully extracted the lost wire through vascular surgery. Eventually, this report is supposed to increase awareness of this rare and preventable complication and to provide a solution to prevent this complication. Finally, the purpose of this report is to emphasize that surgical extracting is the best intervention to remove the missed guide wire (after 3 months) and this option could be developed, introduced and standardized in appropriate and controlled conditions.