Accidental loss of guidewire during femoral central venous catheterization: A case report

Central venous catheterization is a routine procedure performed in the emergency department and intensive care unit. Awareness of potential complications related to guidewire is of utmost importance. The loss of guidewire into circulation during this procedure is a rare and preventable complication. We report a case of accidental loss of guidewire in a 66-year-old female patient during femoral venous catheterization. After cannulation of the right femoral vein and smooth insertion of the guidewire, the guidewire accidentally slipped while railroading the catheter over the guidewire. The cardiothoracic and vascular surgeon immediately explored it under general anesthesia, and the full length of the guidewire was retrieved successfully. The intraoperative period remained uneventful, and the patient was extubated with stable hemodynamics. Everyone should be aware of all possible problems which can be encountered during the procedure and complications thereafter. To avoid this rare complication, certain precautions need to be strictly followed. First, holding the guidewire during catheterization is an important step to be practiced to prevent complications associated with a lost guidewire. Second, the whole procedure should always be closely supervised by a senior colleague during its attempt by an inexperienced or junior trainee. In addition to it, the use of a checklist may help to identify and prevent its occurrence. In spite of all this, if this complication occurs, then active management for its retrieval is very important to avoid further complications related to circulating guidewire.