CTICasesIatrogenic Guide Wire Malposition and Looping
Imaging findings
Chest radiograph shows a hemodialysis guide wire and catheter introduced via a left internal jugular (IJ) approach. The guide wire loops multiple times in the superior vena cava (SVC) and break-off of IJ approach, with a loop extending into the right ventricle.
Key takeaways
Guide wire looping and malposition are potential iatrogenic complications of central venous catheterization. A wire that loops within the right ventricle carries a risk of myocardial perforation or arrhythmias. Management involves gentle fluoroscopic retrieval and repositioning under interventional radiology guidance.
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