Work

Successful Retrieval of a Fractured Balloon Shaft During EVT Using the Inner PIERCE Technique

Year: 2025

Type: article

Abstract: BACKGROUND: Balloon shaft fracture during endovascular therapy is a rare but serious complication, especially in calcified, tortuous vessels. CASE SUMMARY: A woman in her 70s with chronic limb-threatening ischemia presented with recurrent foot ischemia. Balloon angioplasty of the distal anterior tibial artery using the BADFORM (BAlloon Deployment using FORcible Manner) technique resulted in balloon shaft fracture. Conventional retrieval failed owing to vessel tortuosity. Using retrograde access and the inner PIERCE (Percutaneous dIrect nEedle punctuRe of Calcified plaquE) technique-a direct intraluminal puncture and debulking method-the fractured shaft was released and retrieved through an antegrade guide catheter. DISCUSSION: This case demonstrates a minimally invasive salvage strategy using the inner PIERCE technique as an alternative to snaring or microcatheter methods. Atherectomy was not performed because of perforation risk and device limitations. TAKE-HOME MESSAGES: The inner PIERCE technique is an effective percutaneous bailout for balloon shaft entrapment in calcified anatomy. Prompt recognition and troubleshooting may avoid the need for surgery and preserve the limb.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104908

Authors: Tomohide Endo, Hiromitsu Matsui

Institution: Hachinohe City Hospital

Language: English

Topic: Peripheral Artery Disease Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850