Ultrasound Diagnosis of Central Line Guidewire Entrapment With an Inferior Vena Cava Filter

Abstract

Introduction. Guidewire entrapment with an inferior vena cava (IVC) filter during internal jugular vein central line placement is a rare complication. The diagnosis is made by abdominal X-ray or fluoroscopy, and in the majority of cases, the guidewire is removed by interventional radiology, seldom requiring operative removal. Objective. To describe a case of diagnosing central line guidewire entrapment with an IVC by bedside ultrasound. Data source/Case summary. During the placement of a central venous catheter (CVC) in a 63-year-old man—on postoperative day 7 from small bowel resection with presumed peripherally inserted central catheter sepsis—the authors were unable to remove the guidewire. Bedside ultrasound was used to quickly identify the guidewire entrapment down the IVC to the IVC filter. Conclusion. Bedside ultrasound may aid in the diagnosis and expedite the management of guidewire entrapment with IVC filter, which is on the CVC placement complications.