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Balloon rupture during coronary angioplasty
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Balloon rupture during percutaneous coronary angioplasty (PTCA) occurred in 3.6% of cases. Despite intimal tears in some patients, balloon retrieval was successful, and outcomes were not significantly detrimental.
Area of Science:
- Cardiovascular Interventions
- Interventional Cardiology
- Medical Device Safety
Background:
- Percutaneous coronary angioplasty (PTCA) is a common procedure for treating coronary artery disease.
- Complications, such as balloon rupture, can occur during PTCA and may impact patient outcomes.
- Understanding the frequency and consequences of balloon rupture is crucial for procedural safety.
Purpose of the Study:
- To determine the incidence of balloon rupture during PTCA.
- To identify factors associated with balloon rupture, such as lesion calcification.
- To evaluate the clinical consequences and long-term outcomes following PTCA balloon rupture.
Main Methods:
- Retrospective analysis of 1,500 consecutive PTCA procedures.
- Identification of cases with balloon rupture.
- Review of patient records for lesion characteristics, procedural details, and complications.
- Assessment of angiographic restenosis rates in a subset of patients.
Main Results:
- Balloon rupture occurred in 55 patients (3.6%) out of 1,500 PTCA procedures.
- Lesion calcification was present in 12.7% of rupture cases.
- Mean rupture pressure was 10.7 atmospheres; all balloons were retrieved successfully.
- Intimal tears were observed in 32.7% of cases, with 3 patients requiring bypass surgery.
- The restenosis rate at follow-up was 38% in 29 restudied patients.
Conclusions:
- Balloon rupture during PTCA is a rare event with a low incidence.
- Despite potential complications like intimal tears, balloon retrieval is typically uncomplicated.
- PTCA balloon rupture does not appear to be associated with significantly adverse long-term consequences or increased restenosis rates.
Abstract:
Out of a total of 1,500 percutaneous coronary angioplasties (PTCA), 55 (3.6%) were associated with balloon rupture. Lesion calcification was noticed in 7 of these 55 patients (12.7%). Balloon rupture occurred at a mean pressure of 10.7 atmospheres. All balloons were retrieved without difficulty. Intimal tears were noted in 18 (32.7%) cases. Three patients required bypass surgery. In 29 patients restudied angiographically, the restenosis rate was 38%. Balloon rupture during PTCA does not seem to be associated with detrimental consequences.