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Published on: June 18, 2020
Retrieval of ruptured balloon during hepatic venous balloon angioplasty using Dormia basket
Anushree Katiyar1, Chandan J Das2, Piyush Aggarwal1
1Radiodiagnosis, All India Institute of Medical Sciences New Delhi, New Delhi, DL, India.
Insights
A ruptured angioplasty balloon during endovascular stenting for hepatic venous outflow tract obstruction was successfully retrieved using a Dormia basket. This case highlights an effective technique for managing this rare intraprocedural complication.
Area of Science:
- Interventional Radiology
- Vascular Medicine
- Medical Device Complications
Background:
- Hepatic venous outflow tract obstruction can necessitate endovascular intervention.
- Angioplasty balloons are used to treat vessel stenosis but can rupture.
- Balloon rupture is a rare but significant intraprocedural complication.
Purpose of the Study:
- To describe a case of angioplasty balloon rupture during stenting for hepatic venous outflow tract obstruction.
- To present an effective retrieval method for a ruptured angioplasty balloon migrated into small hepatic vein branches.
Main Methods:
- A middle-aged female with hepatic venous outflow tract obstruction underwent stenting and balloon angioplasty.
- A 14 mm x 4 cm balloon used for angioplasty experienced a circumferential tear and distal migration.
- Retrieval was attempted using various methods, with a Dormia basket proving successful.
Main Results:
- The angioplasty balloon ruptured circumferentially during the procedure.
- The ruptured balloon segment migrated distally into smaller branches of the hepatic vein.
- Successful retrieval of the ruptured balloon was achieved using a Dormia basket.
Conclusions:
- Balloon rupture during angioplasty is a manageable complication.
- A Dormia basket can be an effective tool for retrieving ruptured angioplasty balloons from hepatic veins.
- Simple techniques can resolve complex intraprocedural events in endovascular procedures.
Abstract:
Rupture of an angioplasty balloon is a known complication during endovascular procedures. We describe a case of a middle-aged female patient who was diagnosed with hepatic venous outflow tract obstruction. CT showed narrowing at the right hepatic vein ostium, for which the patient was planned for stenting followed by balloon angioplasty. We used a 14 mm×4 cm balloon for angioplasty. During the procedure, there was a circumferential tear in the balloon, which became separated from its shaft and migrated distally into small branches of the vein. Various retrieval methods were employed; ultimately, a Dormia basket proved effective in retrieving the ruptured balloon in our case. A simple technique was helpful in managing this intraprocedural complication.
