- Knotted guidewire trapped intravascularly during central venous catheterisation in a 79-year-old with pneumonia and septic shock, confirmed by imaging.
- Procedure performed without ultrasound guidance, highlighting increased risk of mechanical complications during catheter placement.
- Interventional cardiology successfully extracted the guidewire using an EN Snare device, demonstrating endovascular retrieval as an effective solution.
Br J Cardiol. 2025 Jun 10;32(2):029. doi: 10.5837/bjc.2025.029. eCollection 2025.
ABSTRACT
A 79-year-old woman presents to the hospital with dyspnoea, fever, and hypotension, and is diagnosed with community-acquired pneumonia and septic shock. Resuscitation is initiated with fluids and vasopressors, and a central venous catheter is placed. However, during the procedure, the guide experiences resistance and cannot be removed, becoming trapped. This is confirmed with tomography and reconstruction, demonstrating intravascular position. The patient is then sent to interventional cardiology for extraction, which is successfully performed using the EN Snare (Merit Medical). The significance of this case lies in the complications of not guiding procedures with ultrasound and how to resolve them, such as the guide being trapped in this patient.
PMID:42422144 | PMC:PMC13344463 | DOI:10.5837/bjc.2025.029
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