What question did this study set out to answer?

This report aims to highlight the occurrence of a guidewire-like artifact during central venous catheter insertion and its implications for patient safety.

March 23, 2026Journal of Perioperative Echocardiography0 citationsOpen Access

Reverberation Artifact Mimicking as a Guidewire in the Superior Vena Cava: A Case Report

TAThanigai ArasuSri Padmavati Mahila Visvavidyalayam KGKrishnaP GouravCreative Commons KSKulbhushan SainiAll India Institute of Medical Sciences Raipur

Key Points

This report aims to highlight the occurrence of a guidewire-like artifact during central venous catheter insertion and its implications for patient safety.
Description of a case involving central venous catheter insertion using the Seldinger technique.
Use of transthoracic echocardiography to visualize the superior vena cava.
Identification of a guidewire-like artifact during the echocardiography examination.
Discovery of a guidewire-like artifact that could mislead catheter placement.
Proposed a maneuver to distinguish between true guidewire and the artifact.
Emphasized the importance of guidewire confirmation to avoid complications.

Abstract

Central venous catheter (CVC) insertion is almost universal in patients undergoing cardiac surgery and is commonly done by Seldinger technique.During CVC insertion, catheter malposition, carotid artery cannulation, or venous malposition is common; hence, guidewire confirmation in the superior vena cava (SVC) before CVC insertion is the best way to avoid complications.SVC is best visualized in the subcostal bicaval view in transthoracic echocardiography (TTE).However, on the flip side, there is always a possibility of artifacts in echocardiography leading to misguidance.We report a guidewire-like artifact (GLA) in the SVC, which was incidentally found during the TTE examination.Additionally, we suggest a simple maneuver to differentiate a true guidewire from GLA.

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