DOI: https://doi.org/10.36347/sjams.2025.v13i03.020

Pages: 742-745

Guidewire accidental migration during femoral hemodialysis catheter placement is a rare but serious complication that can lead to critical conditions such as vessel perforation or cardiac arrythmia. We report a case of a 67-year-old woman with oliguric acute renal failure associated de acute pulmonary edema necessitating an urgent hemodialysis session. Guidewire accidentally migrated during femoral catheter insertion using the Seldinger technique. Radiographies revealed unintended migration of the guidewire. Immediate recognition allowed for prompt removal of the guidewire under real-time imaging via endovascular intervention, ensuring innocuous withdrawal of the foreign body and preventing further complications. This case highlights the importance of imaging guidance in vascular access procedures and emphasizes the need for standardized protocols alongside with sufficient anatomical apprehension and operator training to minimize such risks and improve patient safety.