Zhao Shenyu, Wang Zhe, Zhao Yu
Department of Vascular Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Medicine (Baltimore). 2019 Jul;98(29):e16513. doi: 10.1097/MD.0000000000016513.
Central venous catheterization is a common tool used to monitor central venous pressure and administer fluid medications in patients undergoing surgery. The loss of a broken guide wire into the circulation is a rare and preventable complication. Here, we report a peculiar case of a missed guidewire puncturing the aortic arch and cerebrum.
A 53-year-old man with complaints of an intermittent headache and right swollen ankle following central venous catheterization.
Using computed tomography; the patient was diagnosed with the loss of a guide wire in his body. The guide wire had migrated to the brain and punctured the vascular wall of the aortic arch.
Due to the risks of surgery, the patient was advised to have a follow-up visit once every 3 months.
At present, the patient could live like a normal person, although he suffers from intermittent headaches.
The loss of a guide wire is a completely preventable complication, provided that a hold on the tip of the wire is maintained during placement, and the correct safety measurements and protocols are followed.
中心静脉置管是一种常用工具，用于监测接受手术患者的中心静脉压并给予液体药物。导丝折断并进入循环系统是一种罕见且可预防的并发症。在此，我们报告一例特殊病例，一根导丝误穿主动脉弓和大脑。
一名53岁男性，在中心静脉置管后出现间歇性头痛和右踝肿胀。
通过计算机断层扫描，患者被诊断为体内有一根导丝。导丝已迁移至脑部并刺穿主动脉弓血管壁。
鉴于手术风险，建议患者每3个月进行一次随访。
目前，患者虽患有间歇性头痛，但能像正常人一样生活。
只要在放置导丝时握住其尖端，并遵循正确的安全措施和规程，导丝丢失是完全可以预防的并发症。
