The injury potential of Fogarty balloon catheters

The problem of arterial injury following embolectomy using a balloon catheter is reviewed. Three illustrative clinical cases are presented. The cause of the arterial injury in these cases was due to rupture of the vessel. The hypotheses were that either the vessel was ruptured by direct penetration or bursting by overdistension of the balloon. The linear appearances of the arterial tear in two patients and a false aneurysm in the third suggested that bursting was the correct explanation. Laboratory investigation was carried out on animals and human cadavers and these confirmed that arterial injury and bursting can be caused by over-distension of the balloon catheter. If the maker's recommendations are strictly adhered to; that is, the balloon should not be over-inflated and the correct volume of fluid used then rupture of the artery is unlikely by occur.