1
|
Chauhan BPS, Dholakia B, Khan A, Hirani C, Kumar S, Mahakul DJ, Katyal A, Nazir W, Singh D. Percutaneous femoral access: Stuck guide wire, decannulation difficulty due to unravelling and knotting. J Cerebrovasc Endovasc Neurosurg 2024:jcen.2024.E2023.06.002. [PMID: 38528441 DOI: 10.7461/jcen.2024.e2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/20/2023] [Indexed: 03/27/2024] Open
Abstract
Percutaneous techniques for femoral arterial access are increasingly being performed due to advances in endovascular cerebral procedures, as they provide a less morbid and minimally invasive approach than open procedures. Common complications associated with this peripheral puncture include hematoma, bleeding, pseudoaneurysm, arteriovenous fistula, retroperitoneal bleeding, inadvertent venous puncture, dissection, etc. The retrograde femoral access is currently the most frequently used arterial access as it is technically straightforward, allows for the use of larger size sheaths and catheters, allows repeated attempts, etc. Although being technically less challenging, grave complications can occur due to hardware failure. Here, we present a case of unruptured posterior inferior cerebellar artery (PICA) aneurysm, who underwent uneventful diagnostic cerebral digital substraction angiography (DSA) via right femoral artery route on first attempt, but on second attempt for therapeutic intervention, landed up with stuck guide wire and faced decannulation difficulty due to unravelling of guide wire and multiple knot formation, which was finally removed after multiple attempts at pulling and improvised manoeuvres. Such cannulation and decannulation difficulties have been reported multiple times for central venous access, but extremely rarely for femoral routes, making this case a rarity and worth reporting.
Collapse
Affiliation(s)
- Bhanu Pratap Singh Chauhan
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Binita Dholakia
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Ashfaque Khan
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Chirag Hirani
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Satheesh Kumar
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Dibya Jyoti Mahakul
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Abhishek Katyal
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Wajid Nazir
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| | - Daljit Singh
- Department of Neurosurgery, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
| |
Collapse
|
2
|
Yan R, Lei XY, Li J, Jia LL, Wang HX. Removal of a pulmonary artery foreign body during pulse ablation in a patient with atrial fibrillation: A case report. World J Clin Cases 2023; 11:6587-6591. [PMID: 37900217 PMCID: PMC10601018 DOI: 10.12998/wjcc.v11.i27.6587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Foreign bodies in the pulmonary circulation have been documented in the literature and are typically caused by interventional procedures. However, reports of pulmonary artery foreign bodies during femoral vein puncture are rare, and there is no description of this complication from the guidewire surface flows into the pulmonary artery during a pulse ablation in a patient with atrial fibrillation. CASE SUMMARY We described a case in which a linear foreign body suddenly appeared on fluoroscopy image during pulsed ablation of atrial fibrillation. Multiposition angiography showed that the foreign body was currently lodged in the pulmonary artery but was hemodynamically stable. We then chose to use an interventional approach to remove the foreign body from the pulmonary artery. This foreign body was subsequently confirmed to be from the hydrophilic coating of the guidewire surface. This may be related to the difficulties encountered during the puncture of the femoral vein. This is a rare and serious complication of femoral vein puncture. Therefore, we reported this case in order to avoid a similar situation. CONCLUSION Mismatches between interventional devices from different manufacturers used for femoral venipuncture may result in pulmonary artery foreign bodies.
Collapse
Affiliation(s)
- Rui Yan
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China
| | - Xin-Yu Lei
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China
| | - Jun Li
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China
| | - Liang-Liang Jia
- The CT Room of the Imaging Department, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China
| | - Hai-Xiong Wang
- Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan 030000, Shanxi Province, China
| |
Collapse
|
3
|
Eskandarian R, Abdollahpour A, Aghaamoo S, Amini N, Zangian H, Ghods K. A Case Report: Surgical Removal of Missing Guide Wire, Is it the Best Intervention? Bull Emerg Trauma 2022; 10:138-140. [PMID: 35991371 PMCID: PMC9373055 DOI: 10.30476/beat.2021.90494.1255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/20/2021] [Accepted: 06/26/2021] [Indexed: 11/22/2022] Open
Abstract
Nowadays, the use of central venous catheter insertion (CVC), has abundantly increased. It is a common technique in critically ill patients who are admitted to intensive care and emergency departments in order to hemodynamic monitoring and fluid and medication administration. In this report, we express a 28-year-old man who has multiple trauma with decreased level of consciousness during a car accident three months ago and needs intensive care and monitoring by central venous catheter placing. A missed guide wire remaining inside the venous system after peripherally inserted in femoral vein that was incidentally diagnosed by taking a chest X-ray after three months. Although, guide wires are often retrieved by snaring catheter under fluoroscopic guidance and an interventional cardiologist, we have successfully extracted the lost wire through vascular surgery. Eventually, this report is supposed to increase awareness of this rare and preventable complication and to provide a solution to prevent this complication. Finally, the purpose of this report is to emphasize that surgical extracting is the best intervention to remove the missed guide wire (after 3 months) and this option could be developed, introduced and standardized in appropriate and controlled conditions.
Collapse
Affiliation(s)
- Rahimeh Eskandarian
- Interventional Cardiologist, Semnan University of Medical Sciences, Semnan, Iran
| | - Abolfazl Abdollahpour
- Department of Anesthesiology, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Shahrzad Aghaamoo
- Department of Obstetrics and Gynecology, Semnan University of Medical Sciences, Semnan, Iran
| | - Narges Amini
- Department of Cardiac Surgery, Semnan University of Medical Sciences, Semnan, Iran
| | - Hoda Zangian
- Department of Cardiac Anesthesiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Kamran Ghods
- Cardiac Surgeon, Semnan University of Medical Sciences, Semnan, Iran,Corresponding author: Kamran Ghods, Address: Cardiac Surgeon, Associate Professor, Semnan University of Medical Sciences, Semnan, Iran. Tel: +98-23-33451336, e-mail:
| |
Collapse
|
4
|
Zhang W, Cai Y, Jia P, Cheng K. Percutaneous abdominal puncture for catheterization with the assistance of guide wire in lumboperitoneal shunt. World Neurosurg 2022:S1878-8750(22)00825-7. [PMID: 35717013 DOI: 10.1016/j.wneu.2022.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/21/2022]
|
5
|
Chen YF, Ren D, Yao SQ, Geng LD, Su YS, Kang BY, Wang PC. Accurate Placement of Cannulated Screws in Femoral Neck Fractures: Screw and Guide Wire Combined Technique. Orthop Surg 2021; 13:2472-2476. [PMID: 34668325 PMCID: PMC8654675 DOI: 10.1111/os.12994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/13/2021] [Accepted: 02/21/2021] [Indexed: 11/29/2022] Open
Abstract
Cannulated screw fixation is widely used in the treatment of femoral neck fractures. During surgery, we often face the situation that a guide wire needs to be adjusted because of poor positioning in the femoral neck. It is difficult to adjust the direction of the guide wire in the neck of the femur due to its elasticity. This study developed a practical technique to adjust the guide wire to the correct position. When the direction of insertion of the guide wire has deviated, first, measure the length of the guide wire. Second, select the appropriate cannulated screw based on the measurement, and screw the cannulated screw in along the direction of the guide wire to Ward's triangle. Then return the guide wire to the front of the cannulated screw. At this time, the cannulated screw can be used as a built‐in guide, and a screwdriver can be used to fine‐tune the position of the screw to the optimal direction under the X‐ray guidance. Finally, the cannulated screw is screwed in in this direction until it passes through the Ward triangle area, and the guide wire is inserted. This technique can help doctors insert a guide wire more quickly and accurately, reducing intraoperative injury and the operation time.
Collapse
Affiliation(s)
- Yu-Feng Chen
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Dong Ren
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Shuang-Quan Yao
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Lin-Dan Geng
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Yun-Shan Su
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Bo-Yang Kang
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| | - Peng-Cheng Wang
- Department of Traumatology, Hebei Medical University Third Affiliated Hospital, Shijiazhuang, China
| |
Collapse
|
6
|
Du XY, Zhai XD, Liu Z. A clinical retrospective study of percutaneous dilatational tracheostomy without guide wire for critically ill patients. Wien Klin Wochenschr 2021; 133:825-831. [PMID: 33427936 DOI: 10.1007/s00508-020-01799-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to introduce a novel tracheostomy method, the non-guide-wire percutaneous dilatational tracheostomy (NGPDT) technique, and evaluate its effectiveness for critically ill patients undergoing neurosurgery under special conditions. METHODS The clinical data of 48 critically ill patients who underwent NGPDT under special conditions with controlled steps were analyzed retrospectively. The patients' demographic, preoperative state of illness, and diagnosis data were collected. Moreover, their intraoperative and postoperative variables were accessed, e.g., operation times, bleeding, saturation of pulse oxygen (SPO2), and early and late complications related to NGPDT. RESULTS The mean patient age was 47.7 ± 13.7 years. The mean GCS (Glasgow Coma Scale) was 8.1 ± 2.9, and the mean BMI (Body Mass Index) was 25.2 ± 5.6. There were 38 patients with an endotracheal tube. The mean duration of onset to NGPDT was 4.0 ± 1.3 days. The mean operation time was 4.2 ± 1.9 min. There were 41 patients with mild intraoperative bleeding, 5 with moderate bleeding, and 2 with severe bleeding as well as 46 with mild postoperative bleeding and 2 with moderate bleeding. Additionally, 41 patients required complete extubation after NGPDT. The mean duration of incision healing was 4.8 ± 3.1 days. There was 1 patient with a decrease of SPO2 ≥ 10%. Three patients presented with a transient violent cough at the primary tracheostomy stage; however, no patients suffered from pneumothorax, subcutaneous emphysema, false passage, or surgery-related death during this procedure. CONCLUSION Overall, NGPDT with controlled steps is a fast, safe, and microinvasive procedure. It mildly stimulates the trachea with a low rate of complications.
Collapse
Affiliation(s)
- Xiu-Yu Du
- Department of Neurosurgery, The First Affiliated Hospital, Hebei North University, Zhangjiakou, No. 12 of Changqing Road, Qiaoxi District, 075000, Hebei, China.
| | - Xiao-Dong Zhai
- Department of Neurosurgery, The First Affiliated Hospital, Hebei North University, Zhangjiakou, No. 12 of Changqing Road, Qiaoxi District, 075000, Hebei, China
| | - Zhi Liu
- Department of Neurosurgery, The First Affiliated Hospital, Hebei North University, Zhangjiakou, No. 12 of Changqing Road, Qiaoxi District, 075000, Hebei, China
| |
Collapse
|
7
|
Aihole JS. In and out catheterisation; how safe? World J Urol 2021; 40:875-877. [PMID: 33398424 DOI: 10.1007/s00345-020-03573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/12/2020] [Indexed: 11/28/2022] Open
|
8
|
Ootaki Y, Ross GA, Zeller KA. An intra-aortic guide wire: what "knot" to do. Cardiol Young 2020; 30:273-4. [PMID: 31813406 DOI: 10.1017/S1047951119002907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report a rare complication of central venous catheter placement in a 5-month-old baby.
Collapse
|
9
|
Polychronidis G, Hennes R, Engerer C, Knebel P, Schultze D, Bruckner T, Müller-Stich BP, Fischer L. Use of a hydrophilic coating wire reduces significantly the rate of central vein punctures and the incidence of pneumothorax in totally implantable access port (TIAP) surgery. BMC Surg 2017; 17:131. [PMID: 29216858 PMCID: PMC5721482 DOI: 10.1186/s12893-017-0329-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 11/27/2017] [Indexed: 12/30/2022] Open
Affiliation(s)
| | | | - Cosima Engerer
- Department of Surgery, University of Heidelberg, INF 110, 69120, Heidelberg, Germany
| | - Phillip Knebel
- Department of Surgery, University of Heidelberg, INF 110, 69120, Heidelberg, Germany
| | - Daniel Schultze
- Department of Surgery, University of Heidelberg, INF 110, 69120, Heidelberg, Germany
| | - Thomas Bruckner
- Department of Medical Biometry, Institute of Medical Biometry and Informatics (IMBI), Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Beat P Müller-Stich
- Department of Surgery, University of Heidelberg, INF 110, 69120, Heidelberg, Germany
| | - Lars Fischer
- Department of Surgery, University of Heidelberg, INF 110, 69120, Heidelberg, Germany. .,Department of Surgery, Klinikum Mittelbaden Baden-Baden Bühl, Balger Str. 50, 76532, Baden-Baden, Germany.
| |
Collapse
|
10
|
Chevrot A, Pelissier A, Rouzier R. [Mammary duct papilloma: How I do… a microdochectomy wire guided]. ACTA ACUST UNITED AC 2017; 45:632-633. [PMID: 29111292 DOI: 10.1016/j.gofs.2017.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 09/14/2017] [Indexed: 11/16/2022]
Affiliation(s)
- A Chevrot
- Departement of breast and gynecological surgery, Rene-Huguenin center, Curie institute, 92210 Saint-Cloud, France.
| | - A Pelissier
- Departement of breast and gynecological surgery, Rene-Huguenin center, Curie institute, 92210 Saint-Cloud, France
| | - R Rouzier
- Departement of breast and gynecological surgery, Rene-Huguenin center, Curie institute, 92210 Saint-Cloud, France; EA 7285, clinical risks and security in women's health and perinatal health, Versailles-Saint-Quentin-en-Yvelines university, 78180 St-Quentin-en-Yvelines, France
| |
Collapse
|
11
|
Li J, Wang L, Li X, Feng K, Tang J, Wang X. Accurate guide wire of lag screw placement in the intertrochanteric fractures: a technical note. Arch Orthop Trauma Surg 2017; 137:1219-1222. [PMID: 28725919 DOI: 10.1007/s00402-017-2754-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Indexed: 10/19/2022]
Abstract
Cephalomedullary fixations are commonly used in the treatment of intertrochanteric fractures. In clinical practice, one of the difficulties is when we exit the guide wire in a wrong position of femoral neck and insert near the hole again, the guide wire often flow into the previous track. This study develops a surgical technique to direct the guide wire to slip away the previous track and slip into a right position. When guide wire is exited to the cortex of femoral, we let the wire in and out at the cortical layer for several times to enlarge the entry hole. After that, electric drill is inverted, rubbed and entered slowly at a right angle. When guide wire encountered new resistance, the electric drill is turned back instantly. This technique can help trauma and orthopedic surgeons to obtain precision placement of the lag screw after the first try is failed.
Collapse
Affiliation(s)
- Jiang Li
- Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.,Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People's Republic of China.,Department of Orthopedics, Shanghai Pudong New Area People's Hospital, Shanghai, 201200, People's Republic of China
| | - Liao Wang
- Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.,Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Xiaodong Li
- Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.,Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Kai Feng
- Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.,Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Jian Tang
- Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China.,Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Xiaoqing Wang
- Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, No. 639, Zhizaoju Road, Huangpu District, Shanghai, 200011, People's Republic of China. .,Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200011, People's Republic of China.
| |
Collapse
|
12
|
Abstract
INTRODUCTION Extraction of broken femoral nails in peri-implant fractures is becoming an increasingly common problem faced by orthopaedic surgeons. Different closed and open techniques for removal of broken nails have been previously described but due to variations in equipment and fracture configurations these methods are not always easily reproducible. We describe an open surgical technique using simple equipment that can be utilised when other methods of extraction have failed. CASE PRESENTATION AND SURGICAL TECHNIQUE We present a case of a peri-implant fracture secondary to non-union involving a short cephalomedullary nail where the broken distal segment of nail was significantly more distal to the femoral fracture site. After multiple failed attempts at extraction with previously described closed techniques a rectangular cortical window was created 2cm distal to the tip of the broken nail using a saw. An antegrade guide wire was passed through the nail and pulled out of the bony window. A flexible intramedullary reamer was subsequently passed in retrograde fashion over the guide wire and a simple pushout technique was used to push both segments of the broken nail through the original insertion site. An exchange nailing was performed and the cortical window was reattached using a cable. DISCUSSION This is a simple technique that does not require any specialist equipment and does not require the fracture site to be disturbed. The use of a flexible reamer as a pushout device is ideal as there are multiple size options allowing the surgeon to match the size of the medullary canal with the reamer. Furthermore, the flexibility of the reamer allows easy access through a lateral bone window. CONCLUSION Broken femoral nail extraction can be technically challenging and when other closed methods have failed we believe our technique offers a simple alternative that can be added to the armamentarium of solutions.
Collapse
Affiliation(s)
- C Zhao
- Maidstone and Tunbridge Wells Hospitals Trust, Tunbridge Wells, United Kingdom.
| | - G J R Slater
- Maidstone and Tunbridge Wells Hospitals Trust, Tunbridge Wells, United Kingdom.
| |
Collapse
|
13
|
Kim JW, Lee JI, Park KC. Pseudoaneurysm of the deep femoral artery caused by a guide wire following femur intertrochanteric fracture with a hip nail: A case report. Acta Orthop Traumatol Turc 2017; 51:266-9. [PMID: 28457795 DOI: 10.1016/j.aott.2017.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 03/03/2015] [Accepted: 03/28/2015] [Indexed: 02/06/2023]
Abstract
An 85-year-old woman developed severe swelling and pain in the proximal thigh after internal fixation of an intertrochanteric fracture of the femur with a hip nail. In order to identify the causes and determine the effective treatment, angiography was performed. The results of the angiography revealed a pseudoaneurysm of a branch of deep femoral artery. Endovascular embolization was used to treat the pseudoaneurysm. After reviewing all possible causes, we found a mistake in insertion of a guide wire for hip nail. Using intraoperative fluoroscopic images, we found the mal-positioned guide wire located posterior to trochanter on lateral view of hip. This case study reminds us that pseudoaneurysm can occur in a guide wire during hip nailing. Surgeons can avoid this complication with confirmation of lateral and anteroposterior view of hip.
Collapse
|
14
|
Afshar A. Intrapelvic Protrusion of a Broken Guide Wire Fragment during Fixation of a Femoral Neck Fracture. Arch Bone Jt Surg 2017; 5:63-65. [PMID: 28271090 PMCID: PMC5339358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 09/08/2015] [Indexed: 06/06/2023]
Abstract
During fixation of a femoral neck fracture in a 23-year-old male patient with cannulated screws, a broken guide wire fragment inadvertently advanced through the hip joint and protruded into the pelvis. A second surgical approach was needed to remove the broken fragment from the pelvis. Awareness of such a potentially devastating complication will make surgeons more cautious during implementation of orthopedic instruments and increases patient's safety during surgery.
Collapse
Affiliation(s)
- Ahmadreza Afshar
- Department of Orthopaedics, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
15
|
Ansari MAM, Kumar N, Kumar S, Kumari S. Extra Luminal Entrapment of Guide Wire; A Rare Complication of Central Venous Catheter Placement in Right Internal Jugular Vein. Bull Emerg Trauma 2016; 4:240-243. [PMID: 27878131 PMCID: PMC5118578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/21/2016] [Accepted: 08/08/2016] [Indexed: 06/06/2023] Open
Abstract
Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels. The guide wire was coiled with end coursing behind the esophageal wall. Guide wire was removed under fluoroscopic guide manipulation under local anesthesia. We want to emphasize that even though CVC placement is common and simple procedure, serious complication can occur in hands of untrained operator. The procedure should be performed under supervision, if done by trainee. Force should never be applied to advance the guide wire if resistance is encountered.
Collapse
Affiliation(s)
| | - Naveen Kumar
- Department of Surgery, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Shailesh Kumar
- Department of Surgery, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Sarita Kumari
- Department of Surgery, PGIMER, Dr. RML Hospital, New Delhi, India
| |
Collapse
|
16
|
Kitamura K, Yamamiya A, Ishii Y, Sato Y, Iwata T, Nomoto T, Ikegami A, Yoshida H. 0.025-inch vs 0.035-inch guide wires for wire-guided cannulation during endoscopic retrograde cholangiopancreatography: A randomized study. World J Gastroenterol 2015; 21:9182-9188. [PMID: 26290646 PMCID: PMC4533051 DOI: 10.3748/wjg.v21.i30.9182] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 02/25/2015] [Accepted: 04/30/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the clinical outcomes between 0.025-inch and 0.035-inch guide wires (GWs) when used in wire-guided cannulation (WGC).
METHODS: A single center, randomized study was conducted between April 2011 and March 2013. This study was approved by the Medical Ethics Committee at our hospital. Informed, written consent was obtained from each patient prior to study enrollment. Three hundred and twenty-two patients with a naïve papilla of Vater who underwent endoscopic retrograde cholangiopancreatography (ERCP) for the purpose of selective bile duct cannulation with WGC were enrolled in this study. Fifty-three patients were excluded based on the exclusion criteria, and 269 patients were randomly allocated to two groups by a computer and analyzed: the 0.025-inch GW group (n = 109) and the 0.035-inch GW group (n = 160). The primary endpoint was the success rate of selective bile duct cannulation with WGC. Secondary endpoints were the success rates of the pancreatic GW technique and precutting, selective bile duct cannulation time, ERCP procedure time, the rate of pancreatic duct stent placement, the final success rate of selective bile duct cannulation, and the incidence of post-ERCP pancreatitis (PEP).
RESULTS: The primary success rates of selective bile duct cannulation with WGC were 80.7% (88/109) and 86.3% (138/160) for the 0.025-inch and the 0.035-inch groups, respectively (P = 0.226). There were no statistically significant differences in the success rates of selective bile duct cannulation using the pancreatic duct GW technique (46.7% vs 52.4% for the 0.025-inch and 0.035-inch groups, respectively; P = 0.884) or in the success rates of selective bile duct cannulation using precutting (66.7% vs 63.6% for the 0.025-inch and 0.035-inch groups, respectively; P = 0.893). The final success rates for selective bile duct cannulation using these procedures were 92.7% (101/109) and 97.5% (156/160) for the 0.025-inch and 0.035-inch groups, respectively (P = 0.113). There were no significant differences in selective bile duct cannulation time (median ± interquartile range: 3.7 ± 13.9 min vs 4.0 ± 11.2 min for the 0.025-inch and 0.035-inch groups, respectively; P = 0.851), ERCP procedure time (median ± interquartile range: 32 ± 29 min vs 30 ± 25 min for the 0.025-inch and 0.035-inch groups, respectively; P = 0.184) or in the rate of pancreatic duct stent placement (14.7% vs 15.6% for the 0.025-inch and 0.035-inch groups, respectively; P = 0.832). The incidence of PEP was 2.8% (3/109) and 2.5% (4/160) for the 0.025-inch and 0.035-inch groups, respectively (P = 0.793).
CONCLUSION: The thickness of the GW for WGC does not appear to affect either the success rate of selective bile duct cannulation or the incidence of PEP.
Collapse
|
17
|
Park SB, Kim HW, Kang DH, Choi CW, Yoon KT, Cho M, Song BJ. Sphincterotomy by triple lumen needle knife using guide wire in patients with Billroth II gastrectomy. World J Gastroenterol 2013; 19:9405-9409. [PMID: 24409069 PMCID: PMC3882415 DOI: 10.3748/wjg.v19.i48.9405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 09/25/2013] [Accepted: 11/05/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the usefulness of a guide wire and triple lumen needle knife for removing stones in Billroth II (B-II) gastrectomy patients.
METHODS: Endoscopic sphincterotomy in patients with B-II gastrectomy is challenging. We used a new guide wire technique involving sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy. This technique was performed in nine patients between August 2010 and June 2012. Sphincterotomy as described above was performed. Adequate sphincterotomy, successful stone removal, and complications were investigated prospectively.
RESULTS: Sphincterotomy by triple lumen needle knife using guide wire was successful in all nine patients. Sphincterotomy started towards the 4-5 o’clock direction and continued to the upper margin of the papillary roof. Complete stone removal in one session was achieved in all patients. There were no procedure related complications, such as bleeding, pancreatitis, or perforation.
CONCLUSION: In patients with B-II gastrectomy, guide wire using sphincterotomy by triple lumen needle knife through a forward-viewing endoscopy seems to be an effective and safe procedure for the removal of common bile duct stones.
Collapse
|
18
|
Park SK, Yi IK, Lee JH, Kim DH, Lee SY. Fracture of J-tipped guidewire during central venous catheterization and its successful removal under fluoroscopic guidance -A case report-. Korean J Anesthesiol 2012. [PMID: 23198042 PMCID: PMC3506858 DOI: 10.4097/kjae.2012.63.5.457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Central venous catheterization by Seldinger's technique uses a guidewire which may cause complications such as kinking, knotting and fracture. Fractured guidewire may lead to severe outcomes such as embolization, and removal of it may also cause problems such as vessel damage. We experienced a case of right internal jugular venous catheterization complicated by guidewire fracture entrapped in the central venous catheter, and its successful removal under fluoroscopic guidance using snare-loop. The patient recovered without any complications. When resistance is felt during insertion or withdrawal of the guidewire, force should not be applied to the guidewire and care should also be exercised when passing the tissue dilator over the guidewire. Clinicians should be aware of this rare complication and snare-loop technique could be considered as one of the methods for removal of the fractured guidewire.
Collapse
Affiliation(s)
- Sun Kyung Park
- Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Korea
| | | | | | | | | |
Collapse
|
19
|
Savadkoohi S, Shokri J, Savadkoohi H. Evaluation of guide wire cannulation in reduced risk of post - ERCP pancreatitis and facilitated bile duct cannulation. Caspian J Intern Med 2012; 3:368-71. [PMID: 26557288 PMCID: PMC4600134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Pancreatitis is most common complication of post-ERCP and needs to admission at least for one day. The purpose of this study was to assess the efficacy of guide wire for better common bile duct (CBD) cannulation for reducing post-ERCP pancreatitis. METHODS From April 2010 through March 2011, the patients who needed ERCP and referred to Shahid Beheshti and Rouhani Teaching Hospital were entered into the study. Guide wire cannulation (65 subjects) as case group and 78 cases with standard cannulation as control group were performed on them randomly. Data from these cases were collected and analyzed. RESULTS One hundred eighteen (82.5%) patients were females and 28 (17.5%) were males. The mean age of these patients was 56.5±16.8 years. Post- ERCP pancreatitis rate in guide wire group was 6 (9.2%) and in the standard group was 12 (15.4%) (p=0.269). Successful cannulation in these two groups was 67.7% and 67.9%, respectively (p=0.974). CONCLUSION The results show that post- ERCP pancreatitis rate in both groups are similar. Other studies with large number of cases are required to confirm our results.
Collapse
Affiliation(s)
- Shahriar Savadkoohi
- Department of Internal Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran.,Correspondence: Shariar Savadkoohi, Department of Internal Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran. E-mail: , Tel: 0098 111 2252071-3, Fax: 0098 111 2197667
| | - Javad Shokri
- Department of Internal Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Hesam Savadkoohi
- Department of Internal Medicine, Islamic Azad University of Tehran, Tehran, Iran
| |
Collapse
|
20
|
Kayashima H, Ikegami T, Kasagi Y, Hidaka G, Yamazaki K, Sadanaga N, Itoh H, Emi Y, Matsuura H, Okadome K. Liver Parenchyma Perforation following Endoscopic Retrograde Cholangiopancreatography. Case Rep Gastroenterol 2011; 5:487-91. [PMID: 21960953 PMCID: PMC3180667 DOI: 10.1159/000331135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Although endoscopic retrograde cholangiopancreatography (ERCP) is an effective modality for the diagnosis and treatment of biliary and pancreatic diseases, it is still related with several severe complications. We report on the case of a female patient who developed liver parenchyma perforation following ERCP. She underwent ERCP with sphincterotomy and extraction of a common bile duct stone. Shortly after ERCP, abdominal distension was identified. Abdominal computed tomography revealed intraabdominal air leakage and leakage of contrast dye penetrating the liver parenchyma into the space around the spleen. Since periampullary perforation related to sphincterotomy could not be denied, she was referred for immediate surgery. Obvious perforation could not be found at surgery. Cholecystectomy, insertion of a T tube into the common bile duct, placement of a duodenostomy tube and drainage of the retroperitoneum were performed. She did well postoperatively and was discharged home on postoperative day 28. In conclusion, as it is well recognized that perforation is one of the most serious complication related to ERCP, liver parenchyma perforation should be suspected as a cause.
Collapse
Affiliation(s)
- Hiroto Kayashima
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Han HS, Jeon YT, Na HS, Hwang JY, Choi EJ, Kim MH. Successful removal of kinked J- guide wire under fluoroscopic guidance during central venous catheterization -A case report-. Korean J Anesthesiol 2011; 60:362-4. [PMID: 21716566 PMCID: PMC3110296 DOI: 10.4097/kjae.2011.60.5.362] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 11/28/2010] [Accepted: 12/15/2010] [Indexed: 11/10/2022] Open
Abstract
Guidewire-associated complications that occur during the process of central venous catheterization include its kinking, looping, knotting and breakage. The removal of a looped or knotted guidewire is problematic because it can cause vessel damage, major hemorrhage, or embolization of a fractured guidewire. We report a case of guidewire kinking and its successful removal under fluoroscopic guidance.
Collapse
Affiliation(s)
- Hyun-Seok Han
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young-Tae Jeon
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo-Seok Na
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jin-Young Hwang
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun-Joo Choi
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi-Hyun Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| |
Collapse
|
22
|
Lee AYS, Chang MCK, Chen TJ. Successful use of a guide wire to engage an occluded vessel following failure of conventional catheterization techniques in a patient with acute myocardial infarction. Exp Clin Cardiol 2009; 14:e39-e40. [PMID: 19675819 PMCID: PMC2722459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2009] [Accepted: 05/19/2009] [Indexed: 05/28/2023]
Abstract
The present report describes the case of a 43-year-old woman with acute inferior myocardial infarction, in whom the culprit vessel was posteromedially located, and various diagnostic or guide catheters could not be engaged. The culprit vessel was directly cannulated using a guide wire, which allowed for a successful coronary intervention.
Collapse
Affiliation(s)
- Andrew Ying-Siu Lee
- Correspondence: Dr Andrew Ying-Siu Lee, Division of Cardiology, Jen Ai Hospital, 483 Ton Ron Road, Tali, Taichung, Taiwan, Republic of China. Telephone 886-424819900 ext 3304, fax 886-424815332, e-mail
| | | | | |
Collapse
|