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CASE20191006_001
| CORONARY - Complications | |
| Retrieval of Broken Balloon During PTCA | |
| Satish Chirde1 | |
| Shri Datta Hospital And Research Center, India1, | |
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[Clinical Information]
- Patient initials or identifier number:
MT
-Relevant clinical history and physical exam:
53/M, known case of DM, CKD, HTN andrecent(1 and half month back)CVA (non haemorrhagic infarct) was admitted with angina of 3 hour duration .ECG showed acute STE AWMI. On admission p-86/min BP-160/80 mmHg, no LVF, RS/CVSà NAD.
 -Relevant test results prior to catheterization:
His S. Creatinine was 2.4 mg%, LFT CBC Lipids Na/K were normal
- Relevant catheterization findings:
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[Interventional Management]
- Procedural step:
Procedure Details:Route: Rt RadialSheath: 6F TerumoWire for CAG: TerumoPTCA wire: 0.014¡± Runthrough 190 cmBalloon: 2x 10 semicompliantWhen I tried to pull balloon, it was broken from shaft.Balloon remained in vessel and shaft came out.Initially I crossed another RunthroghPTCA wire. Passed another 2.5 x 10 balloon beyond broken balloon. It was inflated up to 6 atm andpulled so that i can pull broken balloon. But it failed and inflated balloononly came out. I entangeled two wires and trired to pull both wires. Duringthis attempt guide came out of LMCA ostium and was hanging in aorta. Tired toangain entangle wires but wire came out from broken balloon. I renegotiated wire, entangled successfully, pulled balloon in guide then whole assembly out offemoral sheath.Lesion was again crossed with wire. Predilated with 2 x10 at 10 atm. 2.75 x 33DES(Pronova XR sirolimus Eluting stent ) was deployed at 14 atm. Excellentresult with TIMI III flow was achieved.No CIN during follow up
 broken balloon shaft.avi entangeled wires and pulled balloon.avi Renegotiated wire again.avi- Case Summary:
Retrieval of broken gadet is nightmare in cath labMy attempt with using balloon was felt. Another difficulty was guide and wire also came out. lukily I could renegotiate wire without embolisation.We can have different methods like using snare but I managed with two wires successfuly
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