Struck M F, Kaden I, Heiser A, Steen M
Department of Plastic and Hand Surgery, Burn Trauma Center, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle/Saale, Germany.
J Vasc Access. 2008 Oct-Dec;9(4):304-6.
The lost guidewire in central venous catheterization is a commonly described complication. The percutaneous endovascular retrieval method is safe and has a very low complication rate.
Guidewires extending to the inferior cava vein are usually retrieved via the femoral vein. Under special circumstances, femoral venous access may be impossible and alternative vascular approaches are required.
We report a case in which we used an alternative vascular approach, from the subclavian site contralateral to the insertion, in a patient with extensive inguinal burn injuries.
Cross-over subclavian retrieval can be an alternative approach for retrieval of a lost guidewire, but it involves an increased risk of puncture-related complications such as pneumothorax.
中心静脉置管时导丝丢失是一种常见的并发症。经皮血管内取出方法安全且并发症发生率极低。
延伸至下腔静脉的导丝通常经股静脉取出。在特殊情况下，可能无法进行股静脉穿刺，需要采用其他血管入路。
我们报告一例广泛腹股沟烧伤患者，采用了与置管对侧锁骨下部位的替代血管入路。
交叉锁骨下取出法可作为导丝丢失时的一种替代方法，但穿刺相关并发症（如气胸）的风险会增加。
