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.
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.