title: It all unraveled from there: case report of a central venous catheter guidewire unraveling.
abstract: BACKGROUND
  Inferior vena cava (IVC) filters can present challenges to emergency physicians in the process of central venous catheter (CVC) placement.
  
  
  METHODS
  A 68-year-old woman presented to the emergency department with severe shortness of breath and was intubated. A central line was placed after the intubation to facilitate peripheral access. A CVC guidewire unraveled during placement after getting caught on an IVC filter. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware of the complications that IVC filters can cause in the placement of CVCs. Imaging and identification of IVC filters beforehand will allow for proper planning of how to manage the case in which a filter catches on the guidewire. Simple anecdotal techniques, such as advancing the guidewire and spinning the guidewire between the fingers, can facilitate the removal of the guide wire from the IVC filter.
authors.affiliation: Emergency Department, Hamot Medical Center, Erie Pennsylvania and the University of Pittsburgh Medical Center, Erie, Pennsylvania.
authors.forename: Samuel
authors.initials: S
authors.lastname: Zerkle
authors.affiliation: Emergency Department, Hamot Medical Center, Erie Pennsylvania and the University of Pittsburgh Medical Center, Erie, Pennsylvania.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Emdadi
authors.affiliation: Emergency Department, Hamot Medical Center, Erie Pennsylvania and the University of Pittsburgh Medical Center, Erie, Pennsylvania.
authors.forename: Marc
authors.initials: M
authors.lastname: Mancinelli
mesh_terms: D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D062905:Central Venous Catheters / Q000009:adverse effects*; D020878:Device Removal; D004868:Equipment Failure; D005260:Female; D005547:Foreign Bodies / Q000209:etiology*; D006801:Humans; D016306:Vena Cava Filters / Q000009:adverse effects*
keywords: IVC filter; J guidewire; Seldinger technique; central venous catheter; inferior vena cava filer; interventional radiology