Shimamoto T, Arai T
Department of Cardiovascular Surgery, Kyoto University Hospital.
Masui. 1997 Mar;46(3):376-8.
Spring guide wires have been widely used for the central venous catheterization with the popularity of the Seldinger technique. We report here an accidental breakage of a spring guide wire during percutaneous catheterization of a subclavian vein. The venipuncture by a plastic catheter over an introducer needle and the insertion of a spring guide wire through the catheter were easily achieved. However, the insertion of an indwelling catheter over the guide wire was difficult to perform, and the pulling out of the guide wire from the catheter was more difficult, which brought the uncoiling of the spring part of the guide wire from the mandrel. The tip of the guide wire was not cut off, and there were no sequelae in the patient. A plastic catheter over an introducer needle for a subclavian venipuncture is so flexible that it is occasionally bent between the clavicle and the first rib after pulling out of the inside needle. Probably, that is the reason of the difficulties of the insertion of an indwelling catheter and the pulling out of a guide wire. The use of a rigid metal needle for the venipuncture is an alternative way to avoid these troubles.
随着Seldinger技术的普及,弹簧导丝已广泛用于中心静脉置管。我们在此报告一例锁骨下静脉经皮置管过程中弹簧导丝意外断裂的病例。通过穿刺针外套塑料导管进行静脉穿刺,并将弹簧导丝穿过导管,操作轻松完成。然而,在导丝上置入留置导管困难,将导丝从导管中拔出更是困难,这导致导丝弹簧部分从心轴上松开。导丝尖端未被切断,患者也未出现后遗症。用于锁骨下静脉穿刺的穿刺针外套塑料导管非常柔软,拔出内针后偶尔会在锁骨和第一肋骨之间弯曲。这可能就是置入留置导管和拔出导丝困难的原因。使用刚性金属针进行静脉穿刺是避免这些问题的另一种方法。