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  • Title: Subclavian vein flexible guidewire knotting. A potential serious complication in hemodialysis patients.
    Author: Koundouris C, Tornaris G, Charopoulos I, Vounasis A, Solomou G.
    Journal: Chirurgia (Bucur); 2004; 99(1):61-4. PubMed ID: 15332641.
    Abstract:
    BACKGROUND: Complications after subclavian vein catheterization are well-documented in the literature. The purpose of this article is to present a case of a rare and potential serious complication of flexible guidewire knotting in subclavian vein catheterization in a hemodialysis patient. METHOD: A 72 year-old woman on hemodialysis due to diabetes has had left upper extremity arteriovenous fistula (AV-F) thrombosed on the scheduled hemodialysis day. A right subclavian vein catheterization for hemodialysis was decided and attempted, that ended up with a flexible guidewire knotting. RESULTS: The flexible guidewire was splinted with the Kit's dilator and after great effort, under radioscopic control the knotting was managed to be unknotted and the guidewire removed. CONCLUSIONS: Our case suggests that a rare and potential serious complication of subclavian vein catheterization for hemodialysis can be successfully managed with appropriate approach and skillful maneuvers.
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