title: Use of video-assisted thoracoscopic surgery to retrieve a broken guidewire.
abstract: Subclavian venous catheterization was once widely used for volume resuscitation, emergency venous access, chemotherapy, parenteral nutrition, and hemodialysis. However, its use has drastically reduced recently because of life-threatening complications such as hemothorax, pneumothorax. In this case, a patient admitted for a scheduled operation underwent right subclavian venous catheterization for preoperative, intraoperative, and postoperative volume resuscitation and parenteral nutrition. The procedure was performed by an experienced senior resident. Despite detecting slight resistance during the guidewire insertion, the resident continued the procedure to the point of being unable to advance or remove it, then attempted to forcefully remove the guidewire, but it broke and became entrapped within the thorax. We tried to remove the guidewire through infraclavicular skin incision but failed. So video-assisted thoracoscopic surgery was used to remove the broken guidewire. This incident demonstrates the risks of subclavian venous catheterization and the importance of using a proper and gentle technique.
authors.affiliation: Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Bucheon, Korea.
authors.forename: Jin-Beom
authors.initials: JB
authors.lastname: Cho
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Park
authors.forename: Ki-Young
authors.initials: KY
authors.lastname: Sung
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Baek
authors.forename: Jun-Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Do-Sang
authors.initials: DS
authors.lastname: Lee
keywords: Broken guidewire; Central venous catheterization; Complications; Subclavian venous catheterization; Video assisted thoracic surgery