Annals of medicine and surgery (2012) · 2025
Left lower extremity venogram and common iliac venoplasty: guidewire-induced arrhythmia.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhitny Vladislav Pavlovich, Dixon Brett, Jannoud Ryan, Primm Aaron N, Do Kenny, Kawana Eric, Vachirakorntong Benjamin, Do Jenifer, Wang Anke, Garre Jean-Paul, Phillips Leroy
Аннотация
INTRODUCTION AND IMPORTANCE: Modern interventional procedures utilizing guidewires for venous and arterial access, while generally safe, can occasionally lead to complications that challenge the skills of anesthesia providers.
CASE PRESENTATION: We describe a case in which an angioplasty guidewire migrated from the left common iliac vein into the main pulmonary artery, resulting in premature ventricular contractions (PVCs). During the procedure, intraoperative electrocardiogram (ECG) monitoring detected multiple PVCs that persisted without spontaneous resolution. Fluoroscopy subsequently revealed the guidewire's migration into the pulmonary artery.
CLINICAL DISCUSSION: The wire was successfully withdrawn under live imaging, which resolved the PVCs without further complications. Guidewire misplacement in venous access procedures is uncommon but can cause mechanical irritation to cardiac tissue, leading to arrhythmias such as PVCs. In this case, timely recognition and intervention prevented further escalation of the arrhythmia.
CONCLUSION: This case underscores the potential for guidewire migration to cause significant intraoperative complications, such as arrhythmias, and emphasizes the importance of vigilant ECG and hemodynamic monitoring during procedures involving guidewires, even those performed on the lower extremities.
CASE PRESENTATION: We describe a case in which an angioplasty guidewire migrated from the left common iliac vein into the main pulmonary artery, resulting in premature ventricular contractions (PVCs). During the procedure, intraoperative electrocardiogram (ECG) monitoring detected multiple PVCs that persisted without spontaneous resolution. Fluoroscopy subsequently revealed the guidewire's migration into the pulmonary artery.
CLINICAL DISCUSSION: The wire was successfully withdrawn under live imaging, which resolved the PVCs without further complications. Guidewire misplacement in venous access procedures is uncommon but can cause mechanical irritation to cardiac tissue, leading to arrhythmias such as PVCs. In this case, timely recognition and intervention prevented further escalation of the arrhythmia.
CONCLUSION: This case underscores the potential for guidewire migration to cause significant intraoperative complications, such as arrhythmias, and emphasizes the importance of vigilant ECG and hemodynamic monitoring during procedures involving guidewires, even those performed on the lower extremities.