Bedside trick!
Scenario: You are inserting an emergent femoral central line in a severely vasculopath patient with exhausted upper vessels. Patient has previous history of IVC filter placement. What would be your worry?
Answer: Dislodgment of Inferior Vena Caval Filter.
Many cases have been reported in literature where IVC filters get dislodged by guidewires during the insertion of central venous catheters. 3 precautions/tricks can prevent this complication
- Limiting the distance that a guidewire is inserted into a vein during central line insertion.
- Inserting the straight end of the guidewire would also be effective.
- Inserting a smaller length central venous catheter (16 cm) instead of full 20 cm length central venous catheter.
Guidewire Dislodgment of Inferior Vena Cava Filters During Insertion of Central Venous Catheters - Vascular and Endovascular Surgery, Vol. 31, No. 5, 587-593 (1997)
