I have never seen or felt a guidewire move in such a way, over 20 years and thousands of lines. However, I did turn my back on an intern circa 2000 and that intern pushed and/or flushed the guidewire into the patient. So I was interested in the 4 references in the article purporting to show that guidewires have wings or feet or that the venous circulation can pull them and overcome the tissue resistance and mass of the wire. Here is a summary:
- Schummer, 2002: This is a series of 4 cases. In case 1 an intern put a catheter in, but it was dislodged and the wire left in the patient. Because the catheter was inserted, the guidewire clearly was pushed or flushed. A second catheter was inserted with the first wire still in the patient. In case 2, an intern flushed the wire through the catheter. In case 3, a PGY5 trainee inserted a catheter successfully but the wire was left in the patient - again a case of pushing it in with the catheter or flushing it in. In case 4, a first-timer successfully inserted the catheter but pushed or flushed the wire in so that it was dangling from the distal end of the catheter and was retrieved. In none of these cases did the guidewire migrate on its own or propelled by respiratory mechanics or the venous circulation.
- Auweiler, 2005: A series of 3 cases, similar to above. In all three cases, the wire was discovered days or weeks after successful cannulation. Thus, the operators pushed or flushed the wire into the circulation during the insertion of the catheter.
- Guo, 2006: Another case of a successful cannulation where the wire was discovered much later protruding from the patient's neck - a case of "wire necessitans". It was pushed or flushed in, it did not migrate prior to catheter insertion.
- Khatami, 2010: Another case of successful catheter insertion where the guidewire was later incidentally discovered.