title: Serial optical coherence tomography images of trapped balloon catheter after bailout stenting.
abstract: The increased use of endovascular interventions has resulted in a growing number of complications pertaining to unretrievable devices. We report a case of balloon dislodgement in a coronary artery during percutaneous coronary intervention (PCI) with bailout stenting using bare metal stent (BMS). We could not retrieve the remnant despite several attempts and techniques. Thereafter, we deployed BMS to bail out thrombus to recover the coronary flow. Emergency surgery was not considered because of high perioperative mortality (EuroSCORE II 55.91%). We did careful follow-up with frequency domain optical coherence tomography images, which revealed thick neointima hyperplasia that completely covered the BMS over the balloon. On the other hand, relevant amounts of thrombus remained on the proximal shaft. In cases where remnants are difficult to retrieve using a percutaneous transcatheter technique and the patients are high-risk for surgery, sealing whole remnants with a BMS is a feasible treatment option.
authors.affiliation: Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.forename: Kensuke
authors.initials: K
authors.lastname: Takagi
authors.forename: Sunao
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D062906:Cardiac Catheters; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D004867:Equipment Design; D004868:Equipment Failure; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D008670:Metals; D010975:Platelet Aggregation Inhibitors
keywords: bail-out stenting; balloon catheter plasmotomy; frequency-domain optical coherence tomography