Broken guide wire--a fault of design?

PURPOSE: To report a potentially serious complication resulting from a faulty guide wire during central venous catheterization.

CLINICAL FEATURES: We report breakage of a guide wire with potential severe implications for a 47-yr-old critical care patient. The tip of the J-wire became lodged in the internal jugular vein, and required fluoroscopic guidance for removal, which occurred without complication.

CONCLUSION: Breakage of a guide wire during central venous catheter insertion has been very rarely reported. However, inherent faults in design or in the manufacturing process of the guide wire could lead to this rare complication. A simple bedside test is proposed to detect breakage in the core section of the guide wire.