# Subclavian Entrapment of a Seldinger Guidewire: A Rare Complication During Central Venous Catheter Placement

## TL;DR

A rare complication occurred when a guidewire became trapped during central venous catheter placement, highlighting the importance of early detection and proper management.

## Contribution

This case report highlights a rare guidewire entrapment complication during catheter placement and emphasizes the need for multidisciplinary management.

## Key findings

- A guidewire loop became entrapped in the clavicle-first rib space during central venous catheter insertion.
- The entrapment occurred in an extravascular location, making removal impossible during the procedure.
- The case underscores the importance of early recognition and multidisciplinary approaches to avoid iatrogenic injury.

## Abstract

Central venous catheter (CVC) placement using the Seldinger technique represents a routine procedure in intensive care units; however, it is still burdened by a non-negligible risk of mechanical complications, often underestimated in clinical practice. Guidewire malposition is a rare event, but it may lead to unpredictable consequences when the course occurs in extravascular locations adjacent to osteomuscular structures. We report the case of a patient with severe cerebral hemorrhage in whom, during CVC insertion, the formation of a guidewire loop in the subclavian region occurred. The loop was completely extravascular and became entrapped in the clavicle-first rib space, making removal impossible during the procedure. This event provides an opportunity to discuss the anatomical mechanisms of malposition, the importance of early recognition, and the multidisciplinary management required to prevent iatrogenic injury.