Kim Seok Hyun, Lee Sang Hyun, Kim Jeongsu, Chun Kook Jin
Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
Front Cardiovasc Med. 2025 Mar 17;12:1565014. doi: 10.3389/fcvm.2025.1565014. eCollection 2025.
An undeflatable stent balloon following its inflation during percutaneous coronary intervention (PCI) is a rare and unpredictable complication that can lead to serious consequences. Currently, there is no standardized protocol for managing this issue.
An 83-year-old man presented with chest pain. Coronary angiography showed a chronic total occlusion (CTO)-like lesion in the proximal left anterior descending coronary artery (LAD). Following stent deployment, the balloon failed to deflate and remained inflated within the LAD. Despite multiple retrieval attempts, the issue remained unresolved. As an alternative to surgical removal, we inflated the balloon beyond its rated burst pressure within the coronary artery. The balloon eventually ruptured and was successfully retrieved; However, this resulted in multiple severe coronary perforations, which were effectively sealed using covered stents.
Balloon deflation failure is an exceptionally rare, unpredictable, and critical complication of PCI. While various troubleshooting strategies exist, inflating an undeflatable balloon beyond its burst pressure should be considered only as a last resort, with thorough preparation for potential complications.
在经皮冠状动脉介入治疗（PCI）过程中，支架球囊充气后无法放气是一种罕见且不可预测的并发症，可能导致严重后果。目前，对于处理这个问题尚无标准化方案。
一名83岁男性因胸痛就诊。冠状动脉造影显示左前降支近端存在类似慢性完全闭塞（CTO）的病变。支架置入后，球囊无法放气，仍在左前降支内保持充气状态。尽管多次尝试取出，问题仍未解决。作为手术取出的替代方法，我们在冠状动脉内将球囊充气至超过其额定破裂压力。球囊最终破裂并成功取出；然而，这导致了多处严重的冠状动脉穿孔，使用覆膜支架有效地进行了封堵。
球囊放气失败是PCI一种极其罕见、不可预测且严重的并发症。虽然存在各种故障排除策略，但将无法放气的球囊充气至超过其破裂压力仅应作为最后手段，并要为潜在并发症做好充分准备。
