What Is the Easiest Way to Remove a Knotted Swan-Ganz Catheter?

Swan-Ganz catheters are routinely used for monitoring of critically ill patients. These catheters can become knotted during the process of insertion, which can pose a challenge for removal. A 63-year-old man underwent placement of a Swan-Ganz catheter, which was knotted and could not be removed. Ultimately, removal was achieved by tightening the knot in the Swan-Ganz catheter against the inlet of its sheath. The catheter and sheath were then pulled together out of the skin in a single motion. Multiple methods have been described to remove such knotted catheters although no consensus exists. A knotted Swan-Ganz catheter can be safely removed by tightening the knot against the inlet of its sheath to reduce the knot size and then simply pulling the catheter and sheath together out of the skin.