Incidental Discovery of Migrated Guidewire from Right Femoral Vein Catheterization: A Case Report

Abstract

Background: Catheterization of central veins can be life-saving for gravely ill patients and remains the mainstay of vascular access for haemodialysis patients especially in the absence of arterovenous fistula. Femoral vein catheterization often comes in handy especially in emergency situations. This is nevertheless fraught with complications including: hemorrhage, femoral artery puncture, femoral nerve injury, pseudoaneurysm, fistula formation, thrombophlebitis, retroperitoneal hemorrhage, bowel perforation, urinary bladder puncture, and guidewire migration. However, guidewire migration has been considered a rare but serious and preventable complication. Case presentation: We report a case of a 64 year old end stage kidney disease patient who was on maintenance haemodialysis using femoral vein catheters as access. Patient was unaware he had a migrated guidewire in situ following femoral vein cannulation by unqualified health professionals. He remained asymptomatic until the migrated guidewire was incidentally discovered during an attempt at right internal jugular vein cannulation for placement of tunneled catheter for haemodialysis. Guidewire extraction was subsequently done through a right neck open surgery. Conclusion: Migrated guidewire is a rare complication of central vein cannulation. It is potentially preventable but prompt extraction should be done immediately if it occurs.