Percutaneous fluoroscopic removal of a knotted Swan–Ganz catheter in a patient with a persistent left‐sided superior vena cava

Abstract

Knotting of intravascular catheters is an uncommon but a well-recognized occurrence. The Swan-Ganz catheter (SGC) is the one that knots most commonly. A case of a knotted SGC is described in a patient with a persistent left-sided superior vena cava, and we propose that the presence of a left-sided superior vena cava is a risk factor for knot formation not previously reported. We review the published work on the risk factors for knot formation and on the techniques used to remove knotted SGC. We describe a technique using a gooseneck snare and Omni Flush catheter (Angiodynamics, Queensbury, NY, USA) to loosen and untie a knotted SGC.

Transjugular retrieval of a knotted peripherally inserted central venous catheter (Epicutaneo-Cava catheter) in a neonate

“…The factors predisposing to knot formation of the intravascular catheters can be divided into patient factors and/or catheter characteristics. 4 …”

Nœud intracardiaque du cathéter de Swan-Ganz: à propos d'un cas

“…Dans l’étude de Bossert incluant 3730 cathéters de Swan-Ganz, le nœud sur cathéter de Swan-Ganz n'a été observé que dans un seul cas. Il peut être favorisé par plusieurs facteurs: la dilatation du ventricule droit, l'insertion de la sonde à un niveau supérieur à 50 cm, le passage du ventricule droit vers l'artère pulmonaire avec un ballonnet qui n'est pas bien gonflé [3, 4]. L'impossibilité de mesurer la pression capillaire pulmonaire doit faire suspecter un nœud sur le cathéter.…”

Transfemoral percutaneous removal of a knotted Swan‐Ganz catheter

“…If untying of the knotted catheter fails, several combined radiological‐percutaneous techniques of extraction have been described [11–14].…”