title: Subclavian vein flexible guidewire knotting. A potential serious complication in hemodialysis patients.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Surgical Department, Sparti General Hospital, Sparti, Greece.
authors.forename: Chr
authors.initials: C
authors.lastname: Koundouris
authors.forename: G
authors.initials: G
authors.lastname: Tornaris
authors.forename: I
authors.initials: I
authors.lastname: Charopoulos
authors.forename: A
authors.initials: A
authors.lastname: Vounasis
authors.forename: G
authors.initials: G
authors.lastname: Solomou
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000009:adverse effects* / Q000295:instrumentation; D004868:Equipment Failure; D005260:Female; D006801:Humans; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D013350:Subclavian Vein