Retrieval of impacted broken balloon by balloon inflation in guiding catheter

Mehta, Vimal; Pandit, Bhagya Narayan; Yusuf, Jamal; Mukhopadhyay, Saibal; Trehan, Vijay; Tyagi, Sanjay

doi:10.1007/s12928-013-0221-9

Cited by 11 publications

(7 citation statements)

References 10 publications

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“…The balloon assembly would minimize the risk for further comorbidities by not localizing the traction to any particular point on the catheter or vascular wall. The balloon technique described here has previously been utilized for retrieving lost stents, primarily in the setting of interventional cardiology procedures (Gupta et al 2005 ; Karaca et al 2016 ; Mehta et al 2014 ). In a prior study, only 2/24 (8.3%) endovascular retrievals were performed using balloon catheters, both of which were used to retrieve broken catheter sheaths.…”

Section: Discussionmentioning

confidence: 99%

Inline balloon-assisted vascular sheath fragment removal

Jamshidi

Chiang

2020

CVIR Endovasc

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Background: Unretrievable foreign bodies are associated with high morbidity and mortality. While the majority of reported cases involve the venous circulation, intra-arterial foreign body displacement have the potential to migrate more distally with a higher risk for dissection and hemorrhagic complications during retrieval. As the number of intravascular procedures continues to increase, there is also likely to be a concomittant increase in the number of retrieval procedures, particular for fractured catheters and sheaths. Although snaring is frequently the traditional, 'go-to' method for retrieval, there are inherent risks of further dislodgement or fracture. Case report: We describe a case that involves retrieval of a fractured sheath that originated in the common femoral artery but migrated into the popliteal artery. Different retrieval approaches were employed, however ultimately balloon assisted, over-the-wire retrieval was the successful approach. Conclusions: We anticipate that over-the-wire, inline-retrieval approaches will continue to grow in popularity and use, particularly with respect to manipulation within the arterial circulation.

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Section: Discussionmentioning

confidence: 99%

Inline balloon-assisted vascular sheath fragment removal

Jamshidi

Chiang

2020

CVIR Endovasc

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“…A deformed/dislodged stent should be recovered when possible. Various retrieval techniques have been described, including the "balloon inflation technique", use of gooseneck snares, grasping forceps, and stent entrapment with the "twowires" technique or with basket devices [1][2][3][4][5][6][7]. However, all of them are time-consuming and if stent retrieval is not possible, particularly in hemodynamically unstable patients, the easier and faster treatment is to use a new stent to crush the dislodged stent against the vessel wall [4].…”

Section: Discussionmentioning

confidence: 99%

“…Although this technique is not widely accepted for LM and proximal LAD dislodgements because of an increased risk for stent thrombosis and restenosis, this approach was recently reported in a published case report, where a dislodged stent was safely crushed to the distal LM/ostial LAD vascular wall in a hemodynamically unstable patient [8]. In case of failure of all percutaneous techniques and according to the dislodgement coronary site (LM or proximal LAD), surgical intervention may represent the last option [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Stent Dislodgement During Coronary Angioplasty Complicated by Left Main Thrombosis: Application of VA-ECMO in The Catheterization Laboratory

Nusca¹

2019

BJSTR

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Stent dislodgement is a serious complication during Percutaneous Coronary Interventions (PCI) and potentially responsible for cardiac arrest, a condition requiring a rapid intervention and restoring of coronary and systemic blood flow. Recently, Veno-Arterial ExtraCorporeal Membrane Oxygenation (VA-ECMO) has become readily applicable even in the setting of the catheterization laboratory. In the present paper we report a case of refractory cardiac arrest due to left main thrombosis complicating stent dislodgement, successfully treated with support of VA-ECMO. The patient gave the consent for publication of this anonymous case report. Clinical CaseA 62-year-old man with multiple risk factors (dyslipidemia, class 1 obesity, type 2 diabetes mellitus, smoking, obstructive sleepapnea syndrome), stable effort angina and a positive stress test was admitted to our Cardiology Department. Coronary angiography carried out through right radial access revealed sub-occlusive stenoses of the proximal Left Anterior Descending (LAD) artery and of the proximal Left Circumflex (LCx) artery, with a 70% stenosis also on the first Obtuse Marginal Branch (OM1) (Figures 1a & 1b) and a chronic total occlusion of the proximal Right Coronary Artery (RCA) (SYNTAX score 22). The patient refused coronary artery bypass grafting; therefore, it was decided to perform angioplasty on LAD, LCx and OM1 after administration of a 600 mg loading dose of clopidogrel and 6500 IU (70 IU/kg) of unfractioned heparin (the patient was already on aspirin at the time of the procedure).A 6-Fr JL 3.5 guiding catheter was used to engage the Left Main (LM) from the right radial access. Firstly, the LAD stenosis was crossed with a 0.014-inch BMW wire (Hi-Torque Balance

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“…Earlier, Mehta V et al [13] reported a successful retrieval of impacted broken balloon by balloon inflation in guiding catheter. Chang WT et al [14] also described two similar cases of successful percutaneous retrieval of ruptured coronary balloon during emergency or elective PCI.…”

Section: Discussionmentioning

confidence: 99%

Balloon assisted trapping (BAT) and retrieval of fractured and impacted coronary angioplasty balloon catheter: simple solution to a complex problem

et al. 2016

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Fracture of catheter fragment in a coronary artery during percutaneous coronary angioplasty is a rare complication, which may result into embolization or impaction leading to complete or near complete occlusion of respective territory, arrhythmia, or rarely sudden death. Here, we report an unusual complication of a broken balloon catheter during angioplasty of a calcified right coronary artery in a 78-year old female which was successfully retrieved by balloon assisted trapping in guiding catheter.

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Retrieval of impacted broken balloon by balloon inflation in guiding catheter

Cited by 11 publications

References 10 publications

Inline balloon-assisted vascular sheath fragment removal

Inline balloon-assisted vascular sheath fragment removal

Stent Dislodgement During Coronary Angioplasty Complicated by Left Main Thrombosis: Application of VA-ECMO in The Catheterization Laboratory

Balloon assisted trapping (BAT) and retrieval of fractured and impacted coronary angioplasty balloon catheter: simple solution to a complex problem

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