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Case Reports in Anesthesiology
Volume 2019, Article ID 5134575, 5 pages
Case Report

Difficult Internal Jugular Central Venous Cannulation Using J-Tip Guidewire with Indwelling Peripherally Inserted Central Venous Catheters

New York Presbyterian Brooklyn Methodist Hospital, USA

Correspondence should be addressed to Preeti Anand; moc.liamg@hsinahomiteerp

Received 30 April 2019; Accepted 9 July 2019; Published 22 July 2019

Academic Editor: Ehab Farag

Copyright © 2019 Preeti Anand et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Central venous cannulation is a commonly performed procedure while managing critically ill patients; increasingly we encounter patients with indwelling wires or devices, like pacemakers, implantable cardioverter defibrillator devices, and peripherally inserted central venous catheters which complicate insertion of central venous catheters further. We present two cases where use of standard J-tip guidewire may have exacerbated the difficulty associated with internal jugular cannulation in presence of peripherally inserted central venous catheters. Recognition and avoidance of possible complications are crucial, and we discuss complexity posed by indwelling peripherally inserted central venous catheters and possible solutions.