Surgical Removal of an Extravascular Knotted J-Tip Guidewire During Subclavian Central Venous Catheterization- A Case Report

Abstract

Guidewire-related complications during central venous catheterization are relatively uncommon. However, they can still occur even with experienced physicians. This report presents a case of an extravascular knotted guidewire during central venous catheterization that required surgical removal. A 72-year-old male patient scheduled for cervical anterior interbody fusion surgery underwent left subclavian venous catheterization one day before the surgery. The J-tip guidewire was inserted through the introducer needle easily without any resistance. During the insertion of the catheter over the guidewire, the catheter did not advance more than 3 cm from the skin. The guidewire was kinked, which was further aggravated by attempts to remove it forcefully, leading to a knot formation that required surgical removal. The patient was discharged one week after the surgery without any additional complications. Safe removal of guidewires is of utmost importance, and preventive measures should be taken to reduce the risk of complications.