Balloon tamponade for central venous catheter-related perforations: A minimally invasive, vessel-sparing case series

Iatrogenic central venous injuries are rare but potentially catastrophic complications of catheter-based interventions. Management options remain limited, with surgical repair often infeasible in high-risk patients and covered stents associated with infection risk and permanent loss of access. Although balloon tamponade has been reported anecdotally in peripheral and arterial injuries, its role in central venous catheter-related perforations has not been systematically studied. This case series addresses this gap by evaluating balloon tamponade as a minimally invasive, vessel-preserving strategy for central venous injuries.

We retrospectively reviewed 7 consecutive cases of superior vena cava, brachiocephalic vein, or common iliac vein perforations managed with fluoroscopy-guided balloon tamponade (2021-2025). Procedural details, immediate hemostasis, complications, and long-term outcomes were assessed over 6 to 12 months of follow-up.

Balloon tamponade achieved complete hemostasis in 6 of 7 patients, avoiding surgical intervention and preserving vascular access. One case was managed conservatively without balloon inflation. No re-bleeding or long-term complications occurred during follow-up. All patients maintained stable vascular access and experienced full clinical recovery.

This case series represents one of the first structured evaluations of balloon tamponade for central venous catheter-related perforations, demonstrating its feasibility, safety, and durable outcomes. By providing vessel-sparing hemostasis without the need for surgical or stent-based intervention, balloon tamponade offers a promising minimally invasive strategy for high-risk patients. These findings highlight its potential role in future management algorithms and underscore the need for prospective studies to standardize the technique and validate its broader application.