Not stuck, but close. This occurred during an insertion that was not in the vein, but "tunneling" along the vein. The wire with difficulty and more pressure than I am accustomed to did come out. The only thing that I could think of was that it was not in the vein, but tunneled outside of the vein.
I did have a PICC exchange get stuck. The original PICC tied itself in a knot and prevented removal. The xray demonstrated the knot in the arm, exactly replicating the knot in the PICC. A surgeon removed the PICC and PULLED hard, which was not what I was willing to do!
I actually had this happen to me. I had just inserted the guidewire and it met resistance, so I attempted to pull the wire back and it was stuck on the needle somehow. I tried to remove the wire, needle and all, figuring I could just restick the patient if I had to. Well, as I was pulling the wire out, with very little force, it started to unravel and before I knew it, ping! The wire snapped. I surprisingly had the wherewithal to grab the part of the wire that was still in the patient and hold on for dear life. In the meantime, I yelled for someone to get my phone and I called IR for help. They pushed a procedure back so I could get the patient down there stat. Just as all the arrangements for made, I hung up, and doesn't it figure? The vasospasm subsided and the wire was free in my hand. I have NEVER felt so relieved in my life!
This has happened to us once in the last 4 years. Someone somehow got the wire not just stuck but tied in a knot part way under an artery. Still hard to imagine how she managed that. Needed vascular surgeon to go in and cut it out.
And just when you think you've heard of everything......
Kent,J and Nedumpara,T (2007) Perforation of the gall bladder by a peripherally inserted central catheter guidewire: 'If it can happen it will'. ANZ Journal of Surgery,77:190-191.
The guidewire "disappeared" during insertion and it was thought that it migrated through the SVC to the IVC,then the hepatic vein,through the liver then through the GB.
The article does not give any details about the PICC insertion nor answer the question I'm sure we all have,which is "How can a reasonable and prudent practitioner think that a guidewire can vanish without a trace and not be a problem?"
a collegue had this happen. Called radiologist who came and pulled it out with some force. She was correct in not doing it herself (which he asked her to do). Wonder if this sort of thing should be done under florscopy instead of blindly. Then you can see and intervene if a part of the wire breaks off and goes shopping.
Not stuck, but close. This occurred during an insertion that was not in the vein, but "tunneling" along the vein. The wire with difficulty and more pressure than I am accustomed to did come out. The only thing that I could think of was that it was not in the vein, but tunneled outside of the vein.
I did have a PICC exchange get stuck. The original PICC tied itself in a knot and prevented removal. The xray demonstrated the knot in the arm, exactly replicating the knot in the PICC. A surgeon removed the PICC and PULLED hard, which was not what I was willing to do!
Gwen Irwin
Austin, Texas
And just when you think you've heard of everything......
Kent,J and Nedumpara,T (2007) Perforation of the gall bladder by a peripherally inserted central catheter guidewire: 'If it can happen it will'. ANZ Journal of Surgery,77:190-191.
The guidewire "disappeared" during insertion and it was thought that it migrated through the SVC to the IVC,then the hepatic vein,through the liver then through the GB.
The article does not give any details about the PICC insertion nor answer the question I'm sure we all have,which is "How can a reasonable and prudent practitioner think that a guidewire can vanish without a trace and not be a problem?"