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Catheter-induced pulmonary artery perforation: pathologic and pathogenic features
1Department of Pathology, McGill University, Montreal, Quebec, Canada.
Abstract:
Perforation of the pulmonary artery due to insertion of a balloon-tipped, flow-directed (Swan-Ganz) catheter is described in four cases. These cases were found in a consecutive series of 270 autopsies done over a 1.5-year period and suggest that the incidence of this complication may be greater than the number of clinically reported cases implies. In three instances, a focal parenchymal hematoma or thrombotic nodule identified the site of rupture. Other pathologic features and the pathogenesis of the perforation are discussed. Difficulties in postmortem diagnosis include distinguishing perforation from hemorrhage due to trauma, thromboembolism, and coagulation abnormalities.
Insights
Pulmonary artery perforation from Swan-Ganz catheter use may be more common than reported. Autopsy findings revealed four cases, highlighting potential underdiagnosis of this serious complication.
Area of Science:
- Cardiovascular Medicine
- Medical Device Complications
- Pathology
Background:
- Swan-Ganz catheters are widely used for hemodynamic monitoring.
- Catheter insertion carries risks, including rare but severe vascular injury.
- Pulmonary artery perforation is a life-threatening complication.