A Retained Guide Wire Following Hemodialysis Dialysis Catheter Insertion; Ultrasound Guided Localization and Retrieval: A Case Report

Abstract

Introduction: Central venous catheterization with the use of Sheldinger technique is a commonly carried out procedure for hemodialysis, medication and monitoring. Migration of guide wire or retained guide wire is a rare and preventable complication of the procedure. This case report brings light on a case of retained guide wire following hemodialysis catheter insertion and its removal by using ultrasound for localisation of guide wire and thereby giving skin incision.

Case summary: Twentyfive years old male, with history of chronic kidney disease and hypertension, taking Amlodipine 10 mg and Torsemide 20 mg presenting with shortness of breath and bilateral limb swelling undergone emergency haemodialysis after insertion of hemodialysis catheter insertion in right internal jugular vein by Seldinger technique under ultrasonography guidance. On the following day, a neglected guide wire was located at the right common iliac vein in check x-ray. With the use of realtime ultrasound curvilinear and linear probe, skin incision was given and dialysis catheter was removed successfully. The procedure was done under general anaesthesia following standard techniques.

Conclusion: Retained guide wire during central venous catheterization is a preventable complication and special care should be given to avoid it. But if an event occurs, point of care ultrasound can be used as a simple and effective way to locate skin incision site and assist the surgeon for the removal of the retained guidewire.