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A Swan-Ganz catheter is an intravenous device used for the invasive measurement of pulmonary capillary wedge pressure and other cardiovascular measurements often utilized in major surgical procedures and critical care units. Several device-related complications were reported in literature - arterial puncture, pneumothorax, inadvertent arterial catheter insertion due to non-ultrasound-guided placement, and formation of knots. This paper presents a case of inadvertent left carotid artery insertion of a Swan-Ganz catheter, complicated by a knot formation requiring surgical intervention to successfully remove the catheter.