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Amy Graham
Bent Guidewire

While placing a 4fr groshong PICC,  the guidewire bent to a 90 degree angle.  I had easy access into the vein, did have to pull the needle back a bit and rotate it to thread the guidewire. Guidewire thread easily. and moved easily in vein.  Attempted to place the introducer and it would not slide in. Pts skin was thick and I did not use a skin nick. I dilated the skin with the introducer. Could not get the introducer to slide in, met resistance.  Started to pull the wire back and felt resistance. Gently pulled the wire back to reveal a 90 degree bend in the wire.  What could have caused this.  Could not straighten wire out enough to thread the introducer over. so I pulled the wire out. Any suggestions would be helpful.  Amy Graham     

Re: bent guidewire:  your

Re: bent guidewire:  your introducer most likely went through the vein.  When you met resistance you might  have been at a bifurcation.  Or the vein might have gone off at an angle that your introducer didn't follow.  Chris


I can't say what happened

I can't say what happened you your case, but getting into a wall of the vein "usually the bottom if you have blood return" or going through the vein, or hitting an obstacle such as where a valve and the vein are connected..... in any case, I always insert my wire very gingerly as to not force or even push against "any" resistance.


True sometimes it happens without notice, but wires are not all created equal.. some love to bend, and others are much better. 

The second mouse gets the cheese!

Mike Brazunas
Amy,  I have seen this


 I have seen this happen a couple of times.  The times that I observed this, the intoducer was being pushed over the wire at a steep angle.  Let's say the wire in nearly flat and the introducer is being pushed in at a perpendicular angle.  Of course, once the kink in the wire occurs, you wind up just pushing against  the kink and the introducer will never go in.  If you do enough PICCs it seems that all these odd things happen eventually.



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