Balloon rupture during coronary angioplasty causing dissection and intramural hematoma of the coronary artery; a case report

Katayama, Toshiro; Sakoda, Naoya; Yamamoto, Fumi; Ishizaki, Masahiko; Iwasaki, Yoshihiro

doi:10.1016/j.jccase.2009.06.002

Cited by 12 publications

(7 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Emboli to the distal coronary circulation may cause slow-flow or no-reflow phenomena. The burst, especially when the balloon ruptures in a pin-hole tear, may cause vascular trauma, including local dissection, perforation, and intramural hematoma [5]. A circumferential tear may be associated with detachment of device components [3,6].…”

Section: Discussionmentioning

confidence: 99%

“…In case of rupture, the operator should withdraw the balloon proximal to the lesion; maneuvering should be careful, so as to avoid entrapment of device materials [8]. Contrast injection should reveal if dissection or perforation is evident, mandating stenting [5]. Management of slow-flow or no-reflow phenomena primarily consists of administering intracoronary vasodilators (e.g.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A Case of Balloon Rupture During Coronary Angioplasty: Slow Flow Requiring Swift Action

Sofidis

Κάρτας

Karagiannidis

et al. 2020

Cureus

View full text Add to dashboard Cite

We describe the case of a middle-aged man undergoing three-vessel coronary angioplasty due to unstable angina. Attempt to predilate a calcified lesion in the left circumflex artery with a semi-compliant balloon, inflated above the rated burst pressure, resulted in balloon rupture. Subsequently, the patient developed ST elevations and became hemodynamically unstable; slow flow in the index vessel was noted. The complication was managed with vasopressor and respiratory support, plus forceful injections of warm saline. Thrombolysis in myocardial infarction (TIMI)-3 flow was eventually restored, and the rest of the procedure was completed uneventfully. Following retrieval of the device, a longitudinal tear in the balloon was observed. This mode of rupture is considered to be safer, when compared to circumferential or pin-hole rupture. Rupture can occur when a balloon is aggressively inflated above nominal pressures and against calcific lesions. The ensuing micro-and macrovascular complications, including slowflow, no-reflow, vessel dissection or perforation, and intramural hematoma, may induce myocardial ischemia and ultimately cardiogenic shock, malignant arrhythmias, and cardiac arrest. Management should be swift, and relies on supportive measures, depending on the degree of complications caused by the rupture.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case of Balloon Rupture During Coronary Angioplasty: Slow Flow Requiring Swift Action

Sofidis

Κάρτας

Karagiannidis

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…Balloon ruptures sometimes lead to more severe complications such as coronary perforation, dissection, and balloon entrapment. [4][5][6] Balloon ruptures may also be caused due to higher balloon pressures during post-dilatation within the stent, but they rarely occur with normal pressures because of sharp calcium spicules protruding into the lumen 6) . In our case, the pinhole balloon rupture occurred with a low balloon pressure during a simple post-stent dilation procedure.…”

Section: Discussionmentioning

confidence: 99%

Observation of the Suspected Sharp Structure Caused a Pinhole Balloon Rupture Using Optical Coherence Tomography and Coronary Angioscopy

Shimooka¹,

Sato

Makiguchi³

et al. 2020

Angioscopy

View full text Add to dashboard Cite

Both optical coherence tomography (OCT) and coronary angioscopy (CAS) are excellent modalities to observe intracoronary structures. Although most coronary artery structures are identifiable by both modalities, some difficulty to assess structures may be present. We report a case of a 76-year-old male who presented with effort angina. Coronary angiography revealed a severe stenotic lesion in the distal right coronary artery (RCA), and hence, percutaneous coronary intervention (PCI) to the lesion was performed. We additionally performed post-dilatation with a noncompliant balloon after stenting, resulting in the balloon rupturing at only 4 atm. When observing the balloon, a pinhole rupture was confirmed. OCT revealed a high signal intensity sharp structure protruding into the lumen, considered to be the cause of the balloon rupture. CAS revealed that the protruding structure was a white-white yellow color. The stent could be expanded using a new noncompliant balloon without any balloon rupture. Postprocedural OCT and CAS showed that the protruding sharp structure disappeared and a part of the structure was pressed onto the lumen. Combining the OCT and CAS findings, we considered the structure might be a micro-calcified nodule or a cholesterol crystal. We hereby report and assess the sharp structure based on the OCT and CAS findings.

show abstract

“…Such cases are important for close contact robots such as used in surgical and assistive fields. Although not common, material failures do occur in medical procedures [e.g., in Katayama et al (2010)]. Moreover, the likelihood of them happening during use increases due to effects such as aging, which causes structural changes leading to increased stiffness in elastomeric materials.…”

Section: Materials Failurementioning

confidence: 99%

On Intrinsic Safety of Soft Robots

Abidi

Cianchetti

2017

Front. Robot. AI

View full text Add to dashboard Cite

The rapidly growing field of soft robotics owes its success to the vast vistas of possibilities they promise. They may be utilized as standalone systems or work in harmony with the existing robotic technologies. Being based on soft and/or flexible materials, soft robots have usually high dexterity and, at the same time, they are also often considered “intrinsically safe.” This is generally true and soft-bodied robots can be considered safer from a mechanical point of view, but this is sometimes improperly used. The identification of possible safety loopholes in soft robots is the subject of this paper. After a general overview of safety in robotics, we reported an overview of the main sources of unsafe conditions that may arise by the use of soft robotics technologies. Safety aspects are discussed in three categories: quasi-static, dynamic, and material failure. Some safety factors exclusive to soft robots such as whiplash-like effect and energy stored in highly strained elements are also introduced. Measures to avoid such unsafe conditions are presented such as establishing operational limits and introduction of inspection regimes and arrest systems

show abstract

Balloon rupture during coronary angioplasty causing dissection and intramural hematoma of the coronary artery; a case report

Cited by 12 publications

References 9 publications

A Case of Balloon Rupture During Coronary Angioplasty: Slow Flow Requiring Swift Action

A Case of Balloon Rupture During Coronary Angioplasty: Slow Flow Requiring Swift Action

Observation of the Suspected Sharp Structure Caused a Pinhole Balloon Rupture Using Optical Coherence Tomography and Coronary Angioscopy

On Intrinsic Safety of Soft Robots

Contact Info

Product

Resources

About