Fracture of cutting balloon microsurgical blade inside coronary artery during angioplasty of tough restenotic lesion: A case report

Haridas, K K; Vijayakumar, M.; Viveka, Kumar; Thachathodiyl, Rajesh; Mahesh, Nalin Kumar

doi:10.1002/ccd.10416

Cited by 18 publications

(6 citation statements)

References 6 publications

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“…Also, CBA devices that apply a level of expansion force far above the fracture threshold of less tough atherosclerotic tissue risk perforating the surrounding arterial wall. These factors must be considered prior to intervention as such incidents defeat the purpose of CBA which is designed to reduce vessel trauma and may also be responsible for the reported cases of arterial rupture and microsurgical blade fracture [41][42][43]. Equally, the presence of atherosclerotic tissue exhibiting toughness values as low as 54 J/m 2 suggests that certain regions of target lesions require far less energy to induce and propagate a controlled cut.…”

Section: Discussionmentioning

confidence: 99%

“…Various complications related to CBA have also been reported including arterial rupture, delayed perforation, and fracture of microsurgical blades [41][42][43]. Arterial injury response to endovascular treatment varies significantly with plaque composition [44][45][46] and it has been previously stated that the mechanisms of CBA affected by plaque composition need to be clarified [47].…”

Section: Introductionmentioning

confidence: 99%

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The influence of composition and location on the toughness of human atherosclerotic femoral plaque tissue

et al. 2016

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The toughness of femoral atherosclerotic tissue is of pivotal importance to understanding the mechanism of luminal expansion during cutting balloon angioplasty (CBA) in the peripheral vessels. Furthermore, the ability to relate this parameter to plaque composition, pathological inclusions and location within the femoral vessels would allow for the improvement of existing CBA technology and for the stratification of patient treatment based on the predicted fracture response of the plaque tissue to CBA. Such information may lead to a reduction in clinically observed complications, an improvement in trial results and an increased adoption of the CBA technique to reduce vessel trauma and further endovascular treatment uptake.This study characterises the toughness of atherosclerotic plaque extracted from the femoral arteries of ten patients using a lubricated guillotine cutting test to determine the critical energy release rate. This information is related to the location that the plaque section was removed from within the femoral vessels and the composition of the plaque tissue,

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The influence of composition and location on the toughness of human atherosclerotic femoral plaque tissue

et al. 2016

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“…Various complications related to CBA have been reported including arterial rupture, delayed perforation, stent strut avulsion, and fracture of microsurgical blades [10–12]. However, very few cases have been reported regarding inadvertent stent extraction as a complication of CBA.…”

Section: Discussionmentioning

confidence: 99%

“…This creates controlled injury and potentially reduces inflammation. Various complications related to CBA have been reported including arterial rupture, perforation, and fracture of microsurgical blades [10–12]. In this case report we present an unforeseen complication of CBA in which a previously deployed stent is inadvertently extracted along with the cutting balloon.…”

Section: Introductionmentioning

confidence: 93%

A Rare and Serious Unforeseen Complication of Cutting Balloon Angioplasty

Vemula

Kalavakunta

Abela

et al. 2014

Case Reports in Cardiology

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Cutting balloon angioplasty (CBA) is one of the adept ways of treating “in-stent restenosis.” Various complications related to cutting balloon angioplasty have been reported including arterial rupture, delayed perforation and fracture of microsurgical blades. Here we report a very unusual and inadvertent extraction of a stent previously deployed in the ramus intermedius coronary branch by a cutting balloon catheter. This required repeat stenting of the same site for an underlying dissection. Even though stent extraction is a rare complication it can be serious due to dissection, perforation, and closure of the artery. Physicians performing coronary artery interventions would need to be aware of this rare and serious complication especially if any difficulty is encountered while withdrawing the cutting balloon. Therefore, after removal, cutting balloon should be examined thoroughly for possible stent dislodgment or extraction when used for “in-stent restenosis.”

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“…1 There are rare reports of atherotome fracture 2 and a Food and Drug Administration adverse event report of a fractured atherotome dislodging and remaining in the patient. 3 We report CB atherotome dislodgement and embolization with successful retrieval in a patient with Alagille syndrome and branch PA stenosis.…”

mentioning

confidence: 99%

Atherotome Dislodgement and Successful Retrieval During Cutting Balloon Pulmonary Angioplasty

DeSena

Ramaciotti

Nugent

2012

Circ: Cardiovascular Interventions

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Fracture of cutting balloon microsurgical blade inside coronary artery during angioplasty of tough restenotic lesion: A case report

Abstract: We report a rare complication due to fracture of the blade of a cutting balloon in the setting of a tough nondilatable restenotic lesion. This resulted in a mural hematoma as a result of dissection of coronary artery.

Cited by 18 publications

References 6 publications

The influence of composition and location on the toughness of human atherosclerotic femoral plaque tissue

The influence of composition and location on the toughness of human atherosclerotic femoral plaque tissue

A Rare and Serious Unforeseen Complication of Cutting Balloon Angioplasty

Atherotome Dislodgement and Successful Retrieval During Cutting Balloon Pulmonary Angioplasty

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