Vascular Devices Research Articles

Enhancing Stent Effectiveness with Nanofeatures.

Drug-eluting stents are an effective therapy for symptomatic arterial obstructions, substantially reducing the incidence of restenosis by suppressing the migration and proliferation of vascular smooth muscle cells into the intima. However, current drug-eluting stents also inhibit the growth of endothelial cells, which are required to cover the vascular stent to reduce an excessive inflammatory response. As a result, the endothelial lining of the lumen is not regenerated. Since the loss of this homeostatic monolayer increases the risk of thrombosis, patients with drug-eluting stents require long-term antithrombotic therapy. Thus, there is a need for improved devices with enhanced effectiveness and physiological compatibility towards endothelial cells. Current developments in nanomaterials may enhance the function of commercially available vascular devices. In particular, modified design schemes might incorporate nanopatterns or nanoparticle-eluting features that reduce restenosis and enhance re-endothelialization. The intent of this review is to discuss emerging nanotechnologies that will improve the performance of vascular stents.

Diagnostic Challenges inInfections related to Spinal Cord Injury

Spinal cord injury (SCI) is an ancient disease, described by Hippocrates and traction techniques were recommended to straighten the spine. Motor vehicle accidents, falls, attempted suicide, gunshot wounds, military conflicts and support injuries are most common cause of SCIs. Most hospitalized SCI patients have nosocomial infection. SCI Patients may suffer from stress, malnutrition, renal failure; receive medications that impair immune responses. Frequent insertion of urologic, vascular, orthopedic, respiratory, gastrointestinal, and neurosurgical devices predispose to various prosthesis-related infections. Diagnostic challenges include inability to recognize the signs and symptoms of cord damage, and delay in diagnosing spinal epidural abscess. Treatment of infection e.g., two opposing factors resulting from changes in body composition in following SCI can alter the disposition of systematically administered antibiotics, such as vancomycin and aminoglycosides. Frequently diagnosed infections in SCI patients are urinary tract infection (UTI), pneumonia, pressure sores, osteomyelitis, infection due to multi-resistant organisms, and intra-abdominal infection. SCI patients are at high risk for Fournier gangrene that affects the perineal and genital regions and usually results from polymicrobial infection.Common pathogens are Staphylococcus aureus, including methicillin resistant Staphylococcus aureus(MRSA),Streptococci, vancomycin resistant Enterococcus(VRE)gram-negative bacilli including ESBL producing Klebsiella pneumoniae and Escherichia coli. Earlydiagnosis, gram negative coverage when initiating empirical antibiotic therapy has lower mortality and better outcomes.

In vitro and in vivo hemocompatibility evaluation of a new dermatan sulfate-modified PET patch for vascular repair surgery.

The development of new vascular devices requires to study the effects of materials on blood cells and on coagulation, both in vitro and in vivo. In this study, we have developed a new material by grafting dermatan sulfate (DS) from shark skin onto polyethylene terephthalate (PET). We have evaluated the haemocompatibility of PET-DS material in vitro by measuring thrombin generation, plasma recalcification time, hemolytic activity, and platelet adhesion and in vivo with a model of vascular patch in rat abdominal aorta. In vitro, our results have shown that PET-DS is a nonhemolytic material, able to inhibit thrombin generation and platelet adhesion. In vivo studies by Doppler echographic evaluation 20 days after implantation have shown that the PET-DS patch was integrated in the vessel wall and covered by a layer of cells. In conclusion, PET-DS has good haemocompatibility properties and could be a promising tool for vascular surgery. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2001-2009, 2017.

Evaluation of Effectiveness of Embolization in Pelvic Congestion Syndrome with the New Vascular Occlusion Device (ArtVentive EOS™): Preliminary Results.

PurposeThis study aimed to collect confirmatory data in support of the safety and efficiency of the ArtVentive EOS™ for the treatment of the pelvic congestion syndrome (PCS). This study was based on the OCCLUDE 1 Study Protocol approved by the Local Ethics Committee.Materials and MethodsA prospective study carried out in June and July 2014 included 12 women aged 21–48 years (mean 31 years) scheduled for PCS embolization using the ArtVentive EOS™. The inclusion criteria were clinical symptoms of PCS documented by transvaginal Doppler ultrasound and pelvic MRI. The pelvic pain was assessed by VAS score from 0 to 10 (0 represents lack of pain and 10 unbearable pain). A decrease in pelvic pain intensity based on the VAS was considered a clinical success.ResultsSuccessful embolization procedures with ArtVentive EOS™ were performed in 11 out of 12 patients. Nine patients underwent unilateral embolization of the left ovarian vein, and two had bilateral embolization of the ovarian veins. Complete ovarian vein occlusion confirmed by post deployment venography was achieved in all 11 patients. Procedures lasted from 19 to 45 min (average 28 min). Pain intensity decrease was observed in all 11 patients—a decrease of 5.6 points—from 7.3 pre-procedure to 1.6 post-embolization (standard deviation: 0.67). In one case, the left ovarian vein was injured by guide wire manipulation with contrast extravasation—not clinically significant.ConclusionsThe use of ArtVentive EOS™ for occlusion of the ovarian veins in PCS patients is safe and effective.

IP247. Surgical Management of Femoropopliteal Vein Aneurysms: A Recent Case Series

Femoropopliteal venous aneurysms (FPVAs) are a rare and potentially lethal disease because they can be a source for pulmonary emboli (PE). These aneurysms are increasingly found on imaging studies for evaluation of musculoskeletal complaints or venous insufficiency. We report our experience over the last 3 years with this disease. All patients with FPVAs treated at Walter Reed National Military Medical Center from January 2012 to December 2015 were identified. A retrospective review of demographic data as well surgical treatment and clinical outcomes was performed. We used a novel technique repairing the two fusiform aneurysms over a balloon used as a mandrel to appropriately size the venorrhaphy. Four patients (3 male and 1 female) with FPVAs, mean age 51 years (range, 44-63 years), were identified. All aneurysms were discovered incidentally on MRI for evaluation of lower extremity musculoskeletal complaints. Three of 4 aneurysms involved the right femoropopliteal vein; one involved the left. Each FPVA was confirmed with venous duplex ultrasound and/or venography. Fifty percent were fusiform and 50% were saccular in morphology. No patient had active thrombus or deep vein thrombosis (DVT) on imaging studies. One patient had a prior history of unprovoked DVT/PE. Each patient was started on therapeutic anticoagulation by the vascular surgery service at their initial clinic visit. Operative management included lateral venorrhaphy in all cases with the use of a balloon mandrel in two cases. An Anastoclip (LeMaitre Vascular) device was used in one case. Each patient was anticoagulated a minimum of 3 to 6 months postoperatively. All 4 patients had normal appearing femoropopliteal veins on follow-up duplex US. Surgery is the treatment of choice for all saccular FPVAs, fusiform FPVAs > 2 cm, and any FPVA in patients with a history of DVT/PE. Lateral venorrhaphy with or without tangential aneurysmectomy is the surgical treatment of choice. The use of a balloon mandrel can simplify lateral venorrhaphy in cases of fusiform morphology. Anticoagulation should be initiated at the time of diagnosis and continued after surgery for a minimum of 3 to 6 months.

The diagnosis and interventional management of pulmonary arteriovenous malformations.

Pulmonary arteriovenous malformations (PAVM) describe a broad group of complex vascular malformations, often associated with multi-system diseases and with palliated complex congenital heart disease. They can have major clinical consequences, resulting in strokes, cerebral abscesses, cyanosis and, infrequently, rupture into the pleural space. The best approach to their investigation and interventional treatment is via a multidisciplinary pathway which should be focused in high-volume centres with on-site thoracic and cardiovascular surgical back-up. The availability of computed tomography (CT) and a broad cathlab inventory aid procedural planning and success. The results of interventional treatment are very encouraging and are applicable to an increasingly broad group of patients thanks to improvements in interventional techniques and a significant expansion of the inventory of vascular occlusion devices.

Abstract 653: Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in Mini-pig Model

Objective: Appropriate animal models of atherosclerotic plaque are crucial for the investigation of the pathophysiology of atherosclerosis, as well as for the evaluation of the efficacy and safety of vascular devices. Therefore, we aimed to develop a novel animal model that would be suitable for the study of the advanced atherosclerotic lesions in vivo. Methods: Atherosclerotic plaque was induced in 32 sites of 8 mini-pigs by combining a high cholesterol diet, endothelial denudation, and injection into the vessel wall with either saline or inflammatory proteins (high-mobility group protein B1 [HMGB1] and tumor necrosis factor [TNF]-α) using a Cricket™ Micro-infusion catheter. In vivo imaging with optical coherence tomography (OCT) was performed to detect the plaque characteristics at follow-up after 10 weeks. All tissues were harvested for histological evaluation. Results: Intima area/plaque area tended to be higher in the HMGB1, and TNF-α groups compared to the saline injected group (p=0.015). Advanced plaques were more frequently observed in the group injected with inflammatory proteins. High degree inflammation occurred in inflammatory protein injected group compared to saline injected group it immunohistochemistry stain using HMGB1 (p<0.001), RAGE (p=0.003), TNF-α antibody (p<0.001) and CD68 antibody (p=0.005). Quantitative imaging evaluation at minimal lumen diameter and percentage of diameter stenosis were also not significantly different among all group. OCT demonstrated that lipid rich plaques were more frequently detected in the inflammatory protein group (saline group: 2/11 [18%], HMGB1 group: 9/11 [82%] and TNF-α group: 5/10 [50%]). Conclusion: Direct injection of inflammatory proteins into the vessel wall significantly increased inflammation occurrence and induced lipid rich plaques. These data indicate that this mini-pig model of atherosclerotic lesion formation via direct injection of pro-inflammatory proteins into the vessel wall is useful for in vivo studies investigating atherosclerosis. Key words: mini-pig model, atherosclerosis, balloon injury, inflammatory protein

Bioresorbable silicon electronics for transient spatiotemporal mapping of electrical activity fromthe cerebral cortex.

Bioresorbable silicon electronics technology offers unprecedented opportunities to deploy advanced implantable monitoring systems that eliminate risks, cost and discomfort associated with surgical extraction. Applications include post-operative monitoring and transient physiologic recording after percutaneous or minimally invasive placement of vascular, cardiac, orthopedic, neural or other devices. We present an embodiment of these materials in both passive and actively addressed arrays of bioresorbable silicon electrodes with multiplexing capabilities, that record in vivo electrophysiological signals from the cortical surface and the subgaleal space. The devices detect normal physiologic and epileptiform activity, both in acute and chronic recordings. Comparative studies show sensor performance comparable to standard clinical systems and reduced tissue reactivity relative to conventional clinical electrocorticography (ECoG) electrodes. This technology offers general applicability in neural interfaces, with additional potential utility in treatment of disorders where transient monitoring and modulation of physiologic function, implant integrity and tissue recovery or regeneration are required.

Polymer-induced central nervous system complications following vascular procedures: spectrum of iatrogenic injuries and review of outcomes

Polymer substances are commonly applied as surface coatings on endovascular catheters and vascular devices. Adverse effects related to their use have been reported, although the overall clinical significance and appropriate methods of detection of these complications have been unclear. In this analysis, we systematically reviewed clinical and diagnostic features in 32 patients (age, 36-87years; mean, 59years) in whom intracranial polymer reactions were documented following vascular interventions. Associated neuroradiologic and neuropathologic findings were variable and included cerebral vasculitis or vasculopathy (63%), abscess or granuloma formation (38%), ischemic infarcts (28%), parenchymal hematomas (28%), white matter change (25%), and/or chemical meningitis (22%). Location(s) of polymer reactions varied and included sites adjacent to and/or downstream from instrument insertion or implantation. Presenting clinical signs included focal neurologic deficits (41%), headache (22%), constitutional symptoms (19%), meningitis (16%), seizure and/or involuntary movements (9%), coma (6%), and syncope (3%). Adverse outcomes included stroke (31%), death (28%), delayed communicating hydrocephalus (9%), steroid dependency (9%), steroid complications (6%), and cerebral volume loss (3%). In some cases, these complications necessitated increased cost and length of medical care. In this review, we highlight the diverse features of polymer-induced reactions involving the central nervous system and summarize distinct diagnostic patterns that may enable earlier premortem detection of these lesions in the postprocedural clinical setting. Further work in this area is necessary to identify additional etiologic, preventative and therapeutic strategies. These data have potentially broad implications pertaining to the safety, efficacy, standards of use, storage, manufacturing, and regulation of new and emerging vascular devices and polymer nanotechnologies.

Prevention of Late Onset Sepsis and Central-line Associated Blood Stream Infection in Preterm Infants.

Late onset sepsis (LOS) and central-line associated blood stream infection (CLA-BSI) contribute toward the mortality and morbidity in prematurely born infants. The aim of this study is to investigate the effects of hospital-wide and unit-based interventions on LOS and CLA-BSI in infants born at <32 weeks gestation. Intensive care, high dependency days and catheter days were obtained from the unit database and blood culture results from a microbiology laboratory database. Poisson regression was used to evaluate the effects of interventions on LOS and CLA-BSI. Quarterly rates of LOS reduced from 26.1 to 2.9 per 1000 intensive care, high dependency days and CLA-BSI from 31.6 to 4.3 per 1000 catheter days between 2007 and 2012. Appointment of a hospital specialist vascular device nurse, a change in the mode of administration of vancomycin, standardization of the hospital skin and hub disinfection policy and the introduction of a venous infusion phlebitis scoring system were associated with a reduction of LOS to 55% (95% confidence interval: 40-74%) and CLA-BSI 45% (95% confidence interval: 33-61%) of pre-intervention levels. The standardization of the neonatal unit policy for skin disinfection and a move to a new building were associated with reductions of LOS to 64% (47-87%) and 54% (34-88%), respectively, and aseptic no touch technique for infusion access with CLA-BSI to 53% (37-75%) of pre-intervention levels. A multifaceted approach involving changes in antimicrobial and skin disinfection policy, training for aseptic no touch technique and surveillance resulted in sustained reduction in LOS and CLA-BSI rates.

Construction of a fucoidan/laminin functional multilayer to direction vascular cell fate and promotion hemocompatibility

Surface biofunctional modification of cardiovascular stents is a versatile approach to reduce the adverse effects after implantation. In this work, a novel multifunctional coating was fabricated by coimmobilization of the sulfated polysaccharide of brown algae fucoidan and laminin to biomimic the vascular intimal conditions in order to support rapid endothelialization, prevent restenosis and improve hemocompatibility. The surface properties of the coating such as hydrophilicity, bonding density of biomolecules and stability were evaluated and optimized. According to the biocompatibility tests, the fucoidan/laminin multilayer coated surface displayed less platelet adhesion with favorable anticoagulant property. In addition, the fucoidan/laminin complex showed function to selectively regulate vascular cells growth behavior. The proliferation of endothelial cells (ECs) on the fucoidan/laminin biofunctional coating was significantly promoted. For the smooth muscle cells (SMCs), inhibitory effects on cell adhesion and proliferation were observed. In conclusion, the fucoidan/laminin biofunctional coating was successfully fabricated with desirable anticoagulant and endothelialization properties which show a promising application in the vascular devices such as vascular stents or grafts surface modification.

Dopamine-assisted deposition of poly (ethylene imine) for efficient heparinization

Mussel-inspired self-polymerization of dopamine in the presence of catechols and amines can be used to form coatings on various substrates. In this work dopamine was co-polymerized with poly (ethylene imine) (PEI) to form coatings on 316L stainless steel (SS). The coating formation was confirmed by Fourier transform infrared spectra (FTIR) and X-ray photoelectron spectroscopy (XPS). Compared with a pure polydopamine coating, such hybrid coating presented a higher ratio of nitrogen and increased zeta potential due to the introduction of PEI components. QCM measurement showed good affinity for heparin immobilization on the amine-rich surfaces. Moreover, the heparin-binding surface significantly suppressed platelet adhesion and activation. Further, the interaction with vascular cells, like endothelial cells (ECs) and smooth muscle cells (SMCs) was also investigated. The heparin coating not only decreased the cytotoxicity of amines on ECs, but also significantly inhibited SMCs proliferation. These results showed that the hybrid coating allowed effective heparin immobilization, providing a promising platform for vascular devices modification.

Quantitative comparison using Generalized Relative Object Detectability (G-ROD) metrics of an amorphous selenium detector with high resolution Microangiographic Fluoroscopes (MAF) and standard flat panel detectors (FPD).

A novel amorphous selenium (a-Se) direct detector with CMOS readout has been designed, and relative detector performance investigated. The detector features include a 25μm pixel pitch, and 1000μm thick a-Se layer operating at 10V/μm bias field. A simulated detector DQE was determined, and used in comparative calculations of the Relative Object Detectability (ROD) family of prewhitening matched-filter (PWMF) observer and non-prewhitening matched filter (NPWMF) observer model metrics to gauge a-Se detector performance against existing high resolution micro-angiographic fluoroscopic (MAF) detectors and a standard flat panel detector (FPD). The PWMF-ROD or ROD metric compares two x-ray imaging detectors in their relative abilities in imaging a given object by taking the integral over spatial frequencies of the Fourier transform of the detector DQE weighted by an object function, divided by the comparable integral for a different detector. The generalized-ROD (G-ROD) metric incorporates clinically relevant parameters (focal-spot size, magnification, and scatter) to show the degradation in imaging performance for detectors that are part of an imaging chain. Preliminary ROD calculations using simulated spheres as the object predicted superior imaging performance by the a-Se detector as compared to existing detectors. New PWMF-G-ROD and NPWMF-G-ROD results still indicate better performance by the a-Se detector in an imaging chain over all sphere sizes for various focal spot sizes and magnifications, although a-Se performance advantages were degraded by focal spot blurring. Nevertheless, the a-Se technology has great potential to provide breakthrough abilities such as visualization of fine details including of neuro-vascular perforator vessels and of small vascular devices.

BJN AWARD RUNNER UP.

career in surgery, day surgery and accident and emergency (A&E) nursing. It was during my time as an A&E sister that my love of IPC was fully ignited by undertaking the role of link IPC practioner for the unit. Since May 2006, I have been a senior IPC nurse in the Barking, Havering and Redbridge University Hospitals Trust and have always had a particular passion for how staff insert and care for vascular devices that have been inserted in vulnerable patients. My vision was to have a standard package for insertion and care of peripheral intravenous access to ensure that patients had the best care from insertion, maintenance of care and removal of lines to reduce the risk of acquiring catheter-related infections. To achieve this involved a phased approach to standardise products, review both nurse and medical staff education to ensure that staff were aware of products available, and look at care expectations to sustain good practice. This was achieved through benchmarking audits of all aspects of peripheral access and care, which informed us about the products within the trust e.g. six different dressings, three different companies providing peripheral cannulas and a variety of skin disinfectants. In addition, the number of peripheral line associated blood stream infections for the previous year was reviewed to provide another benchmark. Once the benchmarking had been completed, a three-stage implementation programme commenced following trialing of different products. Stage one was the standardisation of peripheral line dressings from one company, stage two was the introduction of 2% chlorhexidine/70% alcohol skin disinfectant and stage three was the introduction of a bespoke trust peripheral cannulation pack. Since the introduction of these measures, blood stream infections associated with peripheral lines have reduced by 73%, reducing costs to the trust both in monetary terms and in reduced length of stay, and ensuring that patients are receiving safer, evidence-based care. Aseptic non-touch technique is now mandatory for all healthcare staff who insert, care for or remove cannulas and is part of the induction programme for all new starters. My vision for the future is that all acute trusts have a vascular access team to improve patients’ outcomes. I was honoured to be nominated for a BJN award and delighted to receive second place. BJN

Biodegradable Elastomers with Antioxidant and Retinoid-like Properties.

Intimal hyperplasia (IH) is a type of scarring that involves complex pathophysiological responses of the vasculature to injury, including overproliferation and migration of vascular smooth muscle cells (VSMCs), adventitial fibroblasts, and the activation of macrophages. The objective of this research was to develop a biodegradable polymer with intrinsic properties that would combat the cellular processes that contribute to IH. Citric acid, 1,8-octanediol, and all-trans retinoic acid (atRA) were incorporated into a polyester network via a condensation reaction to form the thermoset poly(1,8-octamethylene-citrate-co-retinate) (POCR). POCR was chemically characterized and assessed for the presence of antioxidant and retinoidlike properties. HNMR and ATR-FTIR confirmed the incorporation of atRA into the backbone of the polymer network. POCR was able to scavenge radicals and inhibit lipid peroxidation. The proliferation and migration of vascular smooth muscle cells cultured on POCR were inhibited, whereas endothelial cell proliferation and migration were not. These results are consistent with the biological effects of atRA. These results are the first to demonstrate the synthesis of a polymer with intrinsic antirestenotic properties for potential use in the fabrication of vascular devices such as stents and vascular grafts.

Progress and challenges in macroencapsulation approaches for type 1 diabetes (T1D) treatment: Cells, biomaterials, and devices.

Macroencapsulation technology has been an attractive topic in the field of treatment for Type 1 diabetes due to mechanical stability, versatility, and retrievability of the macro-capsule design. Macro-capsules can be categorized into extravascular and intravascular devices, in which solute transport relies either on diffusion or convection, respectively. Failure of macroencapsulation strategies can be due to limited regenerative capacity of the encased insulin-producing cells, sub-optimal performance of encapsulation biomaterials, insufficient immunoisolation, excessive blood thrombosis for vascular perfusion devices, and inadequate modes of mass transfer to support cell viability and function. However, significant technical advancements have been achieved in macroencapsulation technology, namely reducing diffusion distance for oxygen and nutrients, using pro-angiogenic factors to increase vascularization for islet engraftment, and optimizing membrane permeability and selectivity to prevent immune attacks from host's body. This review presents an overview of existing macroencapsulation devices and discusses the advances based on tissue-engineering approaches that will stimulate future research and development of macroencapsulation technology. Biotechnol. Bioeng. 2016;113: 1381-1402. © 2015 Wiley Periodicals, Inc.

上行大動脈吻合部仮性瘤に対する血管塞栓プラグおよびステントグラフトによる血管内治療経験

上行大動脈吻合部仮性瘤に対する血管塞栓プラグおよびステントグラフトによる血管内治療経験

Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in a Rabbit Iliac Artery Model.

PurposeAppropriate animal models of atherosclerotic plaque are crucial to investigating the pathophysiology of atherosclerosis, as well as for the evaluation of the efficacy and safety of vascular devices. We aimed to develop a novel animal model that would be suitable for the study of advanced atherosclerotic lesions in vivo.Materials and MethodsAtherosclerotic plaque was induced in 24 iliac arteries from 12 rabbits by combining a high cholesterol diet, endothelial denudation, and injection into the vessel wall with either saline (n=5), olive oil (n=6), or inflammatory proteins [n=13, high-mobility group protein B1 (HMGB1) n=8 and tumor necrosis factor (TNF)-α n=5] using a Cricket™ Micro-infusion catheter. Optical coherence tomography (OCT) was performed to detect plaque characteristics after 4 weeks, and all tissues were harvested for histological evaluation.ResultsAdvanced plaque was more frequently observed in the group injected with inflammatory proteins. Macrophage infiltration was present to a higher degree in the HMGB1 and TNF-α groups, compared to the oil or saline group (82.1±5.1% and 94.6±2.2% compared to 49.6±14.0% and 46.5±9.6%, p-value<0.001), using RAM11 antibody staining. On OCT, lipid rich plaques were more frequently detected in the inflammatory protein group [saline group: 2/5 (40%), oil group: 3/5 (50%), HMGB1 group: 6/8 (75%), and TNF-α group: 5/5 (100%)].ConclusionThese data indicate that this rabbit model of atherosclerotic lesion formation via direct injection of pro-inflammatory proteins into the vessel wall is useful for in vivo studies investigating atherosclerosis.

A training paradigm to enhance performance and safe use of an innovative neuroendovascular device

Training has been important to facilitate the safe use of new devices designed to repair vascular structures. This paper outlines the generic elements of a training program for vascular devices and uses as an example the actual training requirements for a novel device developed for the treatment of bifurcation intracranial aneurysms. Critical elements of the program include awareness of the clinical problem, technical features of device, case selection, and use of a simulator. Formal proctoring, evaluation of the training, and recording the clinical outcomes complement these elements. Interventional physicians should embrace the merits of a training module to improve the user experience, and vendors, physicians, and patients alike should be aligned in the goal of device training to improve its success rate and minimize complications of the procedure.

Pulmonary artery rupture as a complication of Swan-Ganz catheter application. Diagnosis and endovascular treatment: a single centre’s experience

IntroductionThe placement of a Swan-Ganz catheter into the pulmonary artery may lead to a number of complications (2–17%). In less than 0.2% of cases Swan-Ganz catheterization results in serious vascular damage – pulmonary artery rupture (PAR). This paper presents two distinct forms of iatrogenic PAR treated endovascularly using different vascular devices.AimTo evaluate the effectiveness of endovascular treatment and the application of different types of vascular devices in the management of pulmonary artery rupture caused by Swan-Ganz catheterization.Material and methodsIn this retrospective study we evaluated 2 patients in whom Swan-Ganz catheter application was used for perioperative monitoring and resulted in pulmonary artery rupture. This complication was treated endovascularly by means of interventional cardiology.ResultsWe report the cases of 2 patients with a pulmonary artery pseudoaneurysm formed in the perioperative period. In case 1, a single, 4-loop, 3 mm diameter coil was implanted. In case 2, a 5 mm Amplatzer Vascular Plug IV was applied. In both cases, the endovascular approach resulted in total occlusion of the feeding artery and reduced further extravasation of the blood.ConclusionsDespite its extremely low incidence, iatrogenic PAR is a serious, life-threatening complication of Swan-Ganz catheterization that requires urgent attention. Among available methods of treatment, percutaneous embolization is a relatively quick, safe, accurate and highly effective alternative to traumatizing surgery.