Rescue strategy for management of an undeflating dual lumen balloon micro-catheter

Intracranial balloon microcatheters are vital in neurointerventions, yet balloon non-deflation has not been previously reported in the cerebral vasculature.

We describe a 32-year-old woman undergoing embolization for a parieto-occipital arteriovenous malformation who developed failure of deflation of a dual-lumen balloon microcatheter placed in the posterior cerebral artery, despite standard manoeuvres.

Controlled catheter transection distal to the hub, followed by gradual capillary action assisted drainage of diluted contrast, enabled safe balloon collapse and retrieval.

This case highlights a rare but critical complication and presents a practical bailout technique when conventional deflation methods fail, ensuring atraumatic intracranial balloon retrieval.