PMC5241848_01
The chest X-ray shows retained guidewire fragment in the right neck measuring 1 cm in length
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F1
Chest X-ray and ultrasound scan of the neck showed a radio-opaque foreign body in the neck at the level of right clavicle, consistent with retained wire fragment in the right internal jugular vein [Figure 1].
(a) Stored fluoroscopic image shows that the guidewire fragment has been modified after attempted removal with a goose neck snare. (b) Stored fluoroscopic image after attempted removal of the guidewire fragment shows that the guidewire has become radiolucent
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F2
The retained fragment was captured with the snare, but while attempting to pull it out through the snare catheter, the wire fragment "uncoiled" and became radiolucent and no fragment could be retrieved [Figure 2a and b].
Echocardiographic image shows the guidewire fragment extending from the superior vena cava across the tricuspid valve
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F3
An echocardiogram demonstrated a linear echo-bright material extending from the superior vena cava (SVC) to the right atrium and into the right ventricle across the tricuspid valve [Figure 3].
Transesophageal echocardiogram shows the guidewire fragment extending from the superior vena cava to the right atrium
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F4
The vascular snare is shown with the retrieved guidewire. Uncoiling of the guidewire coil spring has resulted in thinning and lengthening of the guidewire fragment
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F5
With transesophageal echocardiographic guidance, the retained guidewire was snared and removed through the right femoral vein [Figure 5].