Brachial artery foreign body
Right wrist pain at recent arterial line site
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Retained guide wire foreign body from previous right radial arterial line. Wire has migrated proximally to the brachial artery. It pierces the subclavian artery superiorly, adjacent to the costocervical trunk and passes posteriorly, to enter the spinal canal.
This patient had a radial arterial line placed in ICU a few weeks prior. It is not clear how the guide wire used to place the line had been retained during the procedure, or how it had migrated proximally. It's possible that migration has resulted from a combination of flushing the line and bending of the arm.
The patient did not have any neurological or vascular compromise. The wire was successfully retrieved by an interventional radiologist. The post retrieval angiogram of the brachial and subclavian arteries showed no injury or bleeding.
Case courtesy of Dr P. Leschke