Q: During insertion of Central Venous Catheter (CVC), resistance is felt during guidewire  advancement. You decided to withdraw wire to check patency of needle in the vessel again. While withdrawing wire you feel some resistance at withdrawal also. What should be your line of action?




Answer:  Simultaneously remove the needle and guidewire.

If resistance is felt during guidewire advancement as well as on withdrawal, needle and guidewire should be removed simultaneously. Trying to remove guidewire only may shear off the wire by the needle and may cause embolization of broken wire piece.