Separation of an arterial catheter from its hub

We would like to report an incident where the catheter of a Vygon Leadercath 20G arterial catheter (Vygon UK, Cirencester, UK) separated from its connection hub and lodged in the patient's radial artery. The Leadercath cannula uses the Seldinger technique in which the arterial catheter is introduced over a guidewire placed through a needle. In replacing arterial lines, it is common practice to introduce a Seldinger wire through the catheter already in place, then remove the original arterial catheter, and introduce the new arterial line over the wire. In this incident the introduction of the Seldinger wire dislodged the body of the catheter from the connection hub, leaving the catheter in the patient's radial artery (Fig. 4). The wire was from an identical, replacement arterial catheter. No excessive resistance to the introduction of the wire was felt and the soft end of the wire was used. Following discussion with the vascular surgeons we agreed to treat this incident expectantly as patient's circulation was not compromised, and the patient had a poor prognosis. The patient subsequently died from unrelated problems. Vygon arterial catheter separated from the hub (top) and an intact catheter (below). We have been informed by Vygon UK that to their knowledge this complication has not occurred before. It is clear that care should be taken when replacing arterial lines in this way.