An attempt to puncture the inflated balloon inside the LAD with the stiff end of a coronary wire that was advanced through a microcatheter failed. ![]() When gentle pull was applied to remove the still inflated balloon from the coronary artery, the proximal shaft completely detached from the distal part at the rupture site (Figure 4 and Figure 5). As the inflated balloon fully occluded the LAD, ST segment elevations were noted on the monitor ECG and the patient began to suffer from angina. ![]() filled with contrast medium (Figure 3), whereas the rupture had obviously taken place in a more proximal part of the catheter. Unusually, the balloon itself remained inflated within the coronary artery, i.e. At 40 atm rupture of the balloon catheter occurred, as evidenced by an abrupt drop in pressure in the indeflator (device to in- and deflate PCI balloons). Pressure was increased slowly into the off-label range > 35 atm, as reported previously. During this second procedure, a shorter ultra-high pressure balloon was inflated in the stent to optimize focussed pressure delivery to the resistant area. The stable patient was transferred the next day to a high-volume center for definitive treatment of the lesion by repeat angioplasty or alternatively rotablation of the implanted stent as a bail-out option. Significant residual stenosis was observed, which could not be resolved by high-pressure angioplasty at 26 atm with a non-compliant balloon catheter, or even at 35 atm with an ultra-high pressure balloon (OPN NC balloon, SIS Medical, Switzerland) (Figure 2). During this procedure, two drug-eluting stents were implanted in a highly calcified and tight stenosis of the LAD (Figure 1). Staged Percutaneous Coronary Intervention (PCI) of a significant proximal stenosis of the Left Anterior Descending (LAD) was scheduled for March 2015. A calcified culprit lesion in the Right Coronary Artery (RCA) was managed by stenting. The first patient, a 65-year-old male, presented to our emergency department with unstable angina without troponin elevation for the first time in January 2015. ![]() We report two cases of an unusual technical complication, arising during percutaneous coronary intervention, and its management. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Raoul Stahrenberg, Head of Cardiac Catheterization Laboratory, Department of Cardiology, Helios Albert-Schweitzer-Klinikum, 37154 Northeim, Germany, Tel: 0049-5551-971885, E-mail: Ma| Accepted: | Published: May 31, 2017Ĭitation: Stahrenberg R, Schillinger W, Jacobshagen C (2017) Shaft Rupture of Ultra-High Pressure Balloons. Raoul Stahrenberg 1, Wolfgang Schillinger 1 and Claudius Jacobshagen 2ġDepartment of Cardiology, Helios Albert-Schweitzer-Krankenhaus, Northeim, GermanyĢDepartment of Cardiology, University of Göttingen, Göttingen, Germany Shaft Rupture of Ultra-High Pressure Balloons
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |