Retrieval of Migrated Guidewire Extending From Right Ventricular Apex to the Inferior Vena Cava via Pigtail-Assisted Snaring

Manaf  Jarallah Yaseen; Wassan Nori; Mohanad  K Shukur Al-Ghanimi

doi:10.5937/scriptamed57-62946

Manaf Jarallah Yaseen Department of Pediatrics, College of Medicine, University of Baghdad, Baghdad, Iraq https://orcid.org/0009-0000-3636-3514
Wassan Nori Mustansiriyah university
Mohanad K Shukur Al-Ghanimi Professor and Consultant Congenital and Structural Interventional Cardiologist, Department of Pediatrics, College of Medicine, University of Babylon, Babylon, Iraq https://orcid.org/0000-0001-5757-5372

DOI: https://doi.org/10.5937/scriptamed57-62946

Keywords: Intravascular, Foreign bodies, Guidewire, Snare kit, Catheter, pigtail, Medical errors

Abstract

Intravascular embolisation of foreign bodies (FB) is a rare, serious complication that may occur during central venous line insertion. A 39-year-old male in a critical condition presented to casualty department with a through-and-through chest gunshot wound. Chest X-ray showed left haemothorax; an urgent chest tube was introduced and central venous access was introduced via the right femoral vein. The guided wire used in the procedure was unintentionally pushed to reach the right ventricular apex. Echocardiography confirmed FB location. Once stabilised, the patient was referred to Iraqi Centre of Cardiac Diseases, where transcatheter retrieval was performed. To stabilise the FB, a 6F pigtail catheter was used to create a U-shaped loop in the guided wire body, coupled with successful snaring. By strategic planning and effective teamwork, retrieval of FB was safely accomplished using a standard catheterisation tool from a high-risk anatomical site without complication.

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