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Successful Retrieval of Ruptured Stent Balloon Catheter During Percutaneous Coronary Intervention
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J INVASIVE CARDIOL 2024. doi:10.25270/jic/24.00043. Epub March 13, 2024.
An 82-year-old woman was admitted for non-ST elevation myocardial infarction. At the coronary angiography, diffuse significant stenosis of the right coronary artery (RCA) was observed (Figure, A). After appropriate positioning and inflating of the drug-eluting stent (4.0 x 28 mm) (Video 1), we determined that complete deflation would not be possible due to the heavy calcification at the site (Figure, B). To remove the stent balloon, the shaft was pulled 2 to 3 times, which ultimately resulted in the rupture of the stent balloon shaft and the entrapment of the stent balloon in a heavily calcified lesion (Figure, C; Video 2). To optimize more space for retrieving the non-deflatable balloon, we attempted to pass an additional wire outward to the entrapped stent strut (Figure, D; Video 3). Subsequently, we carefully passed the microcatheter through the heavily calcified lesion (Figure, E; Video 4). We advanced and inflated a small balloon to create optimal space (Figure, F; Videos 5 & 6).
Despite our attempt to extract the ruptured stent catheter using the anchoring force provided by a 2.0 x 15-mm balloon, the balloon shaft also ruptured (Figure, G). We gradually increased the balloon size, which allowed for the creation of space within the entrapped lesion. Subsequently, we employed the balloon trapping technique with a 2.5 x 15-mm balloon in the guiding catheter, facilitating the successful retrieval of all ruptured devices upon removal of the guiding catheter (Figure, H & J; Video 7). The insufficiently inflated portion of the stent was expanded, and an additional stent was successfully positioned from the RCA (Figure, I).
Affiliations and Disclosures
Fromthe Division of Cardiology, Yeungnam University Medical Center, Daegu, Republic of Korea.
Disclosures: The authors report no financial relationships or conflicts of interest regarding the content herein.
Address for correspondence: Jong-Il Park, MD, Division of Cardiology, 170 Hyeonchung-ro, Nam-gu, Yeungnam University Medical Center, Daegu 42415, Republic of Korea. Email: happypji01@gmail.com
