Retained Guidewire Penetrating the Spinal Cord: An Unusual Cause of Cervicobrachialgia

Retained guidewires are a rare but serious complication of vascular catheterization, most often associated with central venous access. Arterial guidewire retention is exceptionally uncommon, and to our knowledge, no previous case has been documented with migration into the spinal cord. We report the case of a 63-year-old woman who developed progressive cervicobrachialgia due to a retained guidewire extending from the left subclavian artery to the brachial artery, with direct penetration into the cervical spinal cord. The guidewire had been inadvertently left behind during radial artery catheterization and remained undetected for four years. The patient's initial symptoms were managed conservatively, but recurrence prompted advanced imaging that revealed the intravascular foreign body. She underwent a successful open surgical removal through combined subclavian and brachial approaches, followed by an uneventful recovery and significant neurological improvement. This case highlights a unique and unprecedented complication of arterial guidewire retention, emphasizing the potential for delayed neurological sequelae when recognition is postponed. Thorough clinical evaluation with imaging should be considered in patients with unexplained pain after catheter-based procedures. Early detection, meticulous procedural technique, and timely surgical intervention are crucial for preventing long-term morbidity and achieving favorable outcomes.