Patil Shivanand, Setty Natraj, Ramalingam Rangaraj, Mambally Jayasheelan, Manjunath Cholenahally Nanjappa
Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
Interv Med Appl Sci. 2018 Dec;10(4):186-190. doi: 10.1556/1646.10.2018.36.
Although rare, incidents of broken/dislodged fragment of various angioplasty hardwares, including catheters, guidewires, angioplasty balloons, and stents, are being increasingly reported in recent years. Since these broken fragments may cause life-threatening consequences for a patient, it is vital for an interventional cardiologist to be acquainted with different retrieval techniques. Here, we are reporting our observations of several incidents of device dislodgement/fracture during cardiac interventions and their retrieval using simple balloon method.
We present a study of eight patients in whom we attempted to retrieve dislodged/fractured cath-lab hardwares during cardiac interventions, using simple balloon method. These cases include two cases of balloon, three cases of stent, and three cases of guidewire dislodgement/fracture.
Fractured/dislodged cath-lab hardwares were successfully retrieved using a simple balloon method in six out of eight cases (75%), without any need of other retrieval hardwares. We observed no major complications in any patient.
The balloon-assisted retrieval method is a simple, safe, and cost-effective way to avoid complications of endothelial injury, myocardial infarction, emergency coronary artery bypass graft, and sudden cardiac death. This study, particularly the context of retrieval technique used in each case, will offer valuable information to fellow interventional cardiologists.
尽管各类血管成形术硬件（包括导管、导丝、血管成形术球囊和支架）的断裂/移位事件较为罕见，但近年来报告日益增多。由于这些断裂碎片可能给患者带来危及生命的后果，介入心脏病专家熟悉不同的取出技术至关重要。在此，我们报告在心脏介入过程中几起器械移位/断裂事件的观察结果以及使用简单球囊法将其取出的情况。
我们对8例患者进行了一项研究，在心脏介入过程中，我们尝试使用简单球囊法取出移位/断裂的心导管室硬件。这些病例包括2例球囊、3例支架和3例导丝移位/断裂。
8例中有6例（75%）使用简单球囊法成功取出断裂/移位的心导管室硬件，无需其他取出硬件。我们观察到所有患者均未出现重大并发症。
球囊辅助取出法是一种简单、安全且经济有效的方法，可避免内皮损伤、心肌梗死、急诊冠状动脉搭桥术和心源性猝死等并发症。本研究，特别是每个病例中使用的取出技术情况，将为介入心脏病学同行提供有价值的信息。
