The relation between arterial and balloon rupture in experimental angioplasty

Canine carotid, iliac, and femoral arteries underwent transluminal angioplasty with increasing balloon pressure from 4.5 to 12.5 atm. Balloons were selected according to vessel diameter: equal to (zero), 50% larger, and 100% larger than the vessel. The aim of this study was to assess possible disruption of the artery by a bursting balloon. With zero or 50% overdilation, arterial rupture did not occur despite balloon rupture. With 100% overdilation, arterial rupture always preceded balloon rupture. Rupture of all layers of the vessel was caused by severe overdistension, followed by secondary rupture of the balloon because it had lost its external support.