Peripheral Intravenous Cannula Fracture With Intravascular Retention: Early Diagnosis and Management in a Case Report and Literature Review

Fracture of a peripheral intravenous cannula with intravascular retention is a rare but potentially serious complication. The retained catheter fragment may migrate within the venous system and lead to thrombosis, infection, arrhythmia, or embolization. We report the case of a patient in whom fracture of a peripheral intravenous cannula was suspected during routine removal, when the distal segment was found to be missing. On physical examination, a cord-like structure was palpable along the antecubital venous pathway without signs of local inflammation. Bedside ultrasonography was performed and revealed an approximately 5-cm linear intravascular fragment located within a superficial antecubital vein. Given the risk of proximal migration, urgent surgical exploration under local anesthesia was undertaken. The retained fragment was successfully retrieved through a limited venotomy without complications, and the postoperative course was uneventful. This case highlights the importance of early recognition of catheter fracture, particularly when removal appears incomplete or difficult. Prompt localization, preferably using ultrasonography for superficial veins, is essential to guide management and prevent migration. Early surgical retrieval remains the treatment of choice for accessible fragments. Preventive measures, especially avoiding reinsertion of the introducer needle into a partially advanced catheter, are crucial to reduce the risk of this complication.