Intravascular migration of a guidewire during femoral venous catheterization

Abstract

The use of a central catheter in an emergency department is a common practice. The femoral pathway is the emergency route of choice because it is quickly accessible and easy to locate by the operator. However, the complications associated with this gesture remain fairly considerable. The migration of the metallic guide is an exceptional but potentially dangerous complication due to the risk of vascular and cardiac perforation. We report the observation of a 57-year-old patient admitted to the emergency room of the military mohammed V flap hospital for cardiac arrest complicating myocardial infarction. The indication of a femoral venous pathway was made after recovery of spontaneous cardiac activity from the need for vasoactive drug administration, but at the time of insertion of the catheter the metallic guide slipped and migrated along Of the femoral vein. The vascular surgeon was contacted with a decision to transfer the patient to the emergency room as soon as his hemodynamic condition allows. Unfortunately, the patient died a few hours later by cardiogenic shock refractory to vasoactive drugs.