Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft

Rupture of angioplasty balloons is a recognized complication of percutaneous transluminal angioplasty (PTA), occurring in approximately 5-10% of cases. If a rupture occurs, balloon fragments may embolize or cause thrombotic artery occlusion. Immediate recognition of a damaged balloon allows for prom...

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Main Authors: Enes Ljatifi, Mihailo Neskovic, Slobodan Pesic, Aleksandar Babic, Zoran Rancic
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-04-01
Series:Indian Journal of Vascular and Endovascular Surgery
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Online Access:https://journals.lww.com/10.4103/ijves.ijves_126_24
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author Enes Ljatifi
Mihailo Neskovic
Slobodan Pesic
Aleksandar Babic
Zoran Rancic
author_facet Enes Ljatifi
Mihailo Neskovic
Slobodan Pesic
Aleksandar Babic
Zoran Rancic
author_sort Enes Ljatifi
collection DOAJ
description Rupture of angioplasty balloons is a recognized complication of percutaneous transluminal angioplasty (PTA), occurring in approximately 5-10% of cases. If a rupture occurs, balloon fragments may embolize or cause thrombotic artery occlusion. Immediate recognition of a damaged balloon allows for prompt surgical or endovascular removal, depending on the patient’s condition and the location of the balloon inside the vessel. However, unrecognized balloon rupture with delayed symptoms is rare. We present a case of acute lower limb ischemia in a patient with a prior aortobifemoral reconstruction. Several years after an aortobifemoral bypass due to a failing right limb graft, endovascular graft treatment was performed. Eight years later, the patient required surgical treatment for acute ischemia, during which a piece of cup-shaped remnants from a ruptured balloon was found, with a confirmed circumferential balloon tear. Successful surgical extraction restored adequate inflow. The literature reports successful percutaneous retrieval of balloon fragments using techniques such as endoscopic biopsy forceps, grasping forceps, and subintimal angioplasty, but in our case, neither the rupture nor the balloon remnants were identified during the PTA procedure or on angiography eight years later. The retained fragment ultimately caused acute ischemia and limb graft occlusion, necessitating surgical intervention.
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publishDate 2025-04-01
publisher Wolters Kluwer Medknow Publications
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series Indian Journal of Vascular and Endovascular Surgery
spelling doaj-art-ff38b55b0d3b452e80a795449ef670142025-08-20T02:32:15ZengWolters Kluwer Medknow PublicationsIndian Journal of Vascular and Endovascular Surgery0972-08202394-09992025-04-0112216516710.4103/ijves.ijves_126_24Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the GraftEnes LjatifiMihailo NeskovicSlobodan PesicAleksandar BabicZoran RancicRupture of angioplasty balloons is a recognized complication of percutaneous transluminal angioplasty (PTA), occurring in approximately 5-10% of cases. If a rupture occurs, balloon fragments may embolize or cause thrombotic artery occlusion. Immediate recognition of a damaged balloon allows for prompt surgical or endovascular removal, depending on the patient’s condition and the location of the balloon inside the vessel. However, unrecognized balloon rupture with delayed symptoms is rare. We present a case of acute lower limb ischemia in a patient with a prior aortobifemoral reconstruction. Several years after an aortobifemoral bypass due to a failing right limb graft, endovascular graft treatment was performed. Eight years later, the patient required surgical treatment for acute ischemia, during which a piece of cup-shaped remnants from a ruptured balloon was found, with a confirmed circumferential balloon tear. Successful surgical extraction restored adequate inflow. The literature reports successful percutaneous retrieval of balloon fragments using techniques such as endoscopic biopsy forceps, grasping forceps, and subintimal angioplasty, but in our case, neither the rupture nor the balloon remnants were identified during the PTA procedure or on angiography eight years later. The retained fragment ultimately caused acute ischemia and limb graft occlusion, necessitating surgical intervention.https://journals.lww.com/10.4103/ijves.ijves_126_24acute ischemiaballoon rupturepercutaneous transluminal angioplastysurgical retrieval
spellingShingle Enes Ljatifi
Mihailo Neskovic
Slobodan Pesic
Aleksandar Babic
Zoran Rancic
Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft
Indian Journal of Vascular and Endovascular Surgery
acute ischemia
balloon rupture
percutaneous transluminal angioplasty
surgical retrieval
title Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft
title_full Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft
title_fullStr Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft
title_full_unstemmed Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft
title_short Unrecognized Rupture of Angioplasty Balloon: A Hidden Underlying Reason for the Delayed Occlusion of the Graft
title_sort unrecognized rupture of angioplasty balloon a hidden underlying reason for the delayed occlusion of the graft
topic acute ischemia
balloon rupture
percutaneous transluminal angioplasty
surgical retrieval
url https://journals.lww.com/10.4103/ijves.ijves_126_24
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AT mihailoneskovic unrecognizedruptureofangioplastyballoonahiddenunderlyingreasonforthedelayedocclusionofthegraft
AT slobodanpesic unrecognizedruptureofangioplastyballoonahiddenunderlyingreasonforthedelayedocclusionofthegraft
AT aleksandarbabic unrecognizedruptureofangioplastyballoonahiddenunderlyingreasonforthedelayedocclusionofthegraft
AT zoranrancic unrecognizedruptureofangioplastyballoonahiddenunderlyingreasonforthedelayedocclusionofthegraft