Removal of fractured balloon catheter using another balloon inflation in coronary artery: Case report

Entrapment of fractured balloon after angioplasty in an AV access using a covered stent

“…Some have also reported using a second balloon that is passed beyond the fragment, inflated, and pulled back gently to retrieve the fractured fragment into the sheath. 8,9 In a similar situation with circumferential rupture of balloon during angioplasty of AV fistula in two hemodialysis patients, the authors made use of a gooseneck snare to retrieve the balloon and were successful. 2 However; when this was attempted in our case, we were unsuccessful in retrieving the fragment despite multiple efforts.…”

Pci in Patient With Heavy Calcified Lesion. Management and Balloon Rupture Complication

“…Percutaneous transluminal coronary angioplasty (PTCA) is a procedure that is relatively safe and effective to relieve myocardial ischemia (Soylu et al 2006). This procedure actually uses a miniature balloon which is inflated and expanded inside coronary arteries, pressing the plaque into the arterial wall and cracked the wall in order to expand narrowed blood vessels so that the blood can flow (Cleman 1992) and the size of the blood vessels is enough for stenting (Kern 2013).…”

“…High pressure (> 15 atm) of the balloon is required when calcified lesion is being dilated, thus caused rupture of the balloon (Breisblatt 1993, Siddiqi et al 2013. Balloon trapped inside coronary arteries is one further complications of balloon rupture, which should be removed before further complications may take place, such as thrombosis, coronary artery embolization or perforation (Soylu et al 2006). So it is important for the operator to pay attention to NP and RBP of the balloon used when inflation is taking place (Bonzel et al 2012).…”

“…The conventional approach to this complication include the use of snare percutaneously or emergency open heart surgery (Soylu et al 2006, Shantanu 2011. Other strategies to free the trapped balloon is trying to inflate and deflate the balloon alternately with a gentle push and pull the balloon forward and backward with a slight twisting motion, deep seated from GC, using a second wire for gaining the first wire.…”

“…After calculating the above variables, intervention usually begins with the use of balloon-based tool then continued with rotational atherectomy only if inadequate expansion of dilated balloon is found (Nguyen et al 2003, Teirstein et al 2007 (Figure 14). Suzuki (Soylu et al 2006) divides calcified lesion intervention by the diameter of the target coronary arteries (angiography or IVUS). If the size coronary of arteries is small (< 2.5 mm) and the lesions are mostly calcified, then we can directly use rotational atherectomy with rotablator approach to erode calcification.…”