A lady with a broken haemodialysis catheter fragment

Double-lumen haemodialysis catheters are commonly used for temporary venous access in end-stage renal failure patients who require urgent haemodialysis but who do not have mature vascular access. However, catheter dysfunction, such as thrombosis and infection, is not uncommon. Because the replacement of a nonfunctional double-lumen catheter into a new site exposes patients to greater risk of mechanical complications, guide wire exchange of the catheter is an alternative technique to reduce risk, as long as no exitsite or tunnel infection is present w1x. Here, we report a case of accidental migration of a double-lumen catheter fragment into the internal jugular vein during a guide wire exchange. Immediate retrieval of the fragment was successful by way of a percutaneous transfemoral venous approach. Both surgical removal of the intravascular catheter fragment and prolonged hospitalization after surgery were avoided.