Key result
Balloon trapping and pull-back successfully retrieves a trapped IVUS catheter during complex LMS PCI.
Why the study?
With updated guideline recommendations expanding IVUS guidance during complex PCI, operators are more likely to encounter complications such as catheter entrapment and require awareness of potential solutions.
Case Report (n=1)
Balloon trapping and pull-back is a viable percutaneous retrieval method for the uncommon complication of IVUS catheter entrapment during complex PCI.
Answers are grounded in this paper and cite their sources.
Balloon trapping may enable retrieval of entrapped IVUS; leaves open generalizability beyond this single Left Main case.
Background 2024 ESC Guidelines for the management of chronic coronary syndromes updated their recommendation for Intravascular Ultrasound (IVUS) guidance of PCI on anatomically complex lesions, particularly Left Main, bifurcations and long lesions to class 1, level A evidence1. With more widespread use complex PCI operators are more likely to encounter complications and require an awareness of potential solutions. Case Summary A 66-year-old male presented with non-ST elevation acute coronary syndrome. Following PCI to the Left Main Stem the unusual complication of a trapped IVUS catheter was encountered. This was successfully retrieved by balloon trapping and pull-back method. Discussion Literature review demonstrates that IVUS entrapment during complex PCI is an uncommon complication. Heavily calcified lesions, stents <2.5mm and 3rd Generation DES are considered risk factors. Several potential options for retrieval such as balloon trapping and use of Guide extension catheters have been described. This is the first reported case of IVUS entrapment in a large stent in Left Main Stem (LMS).
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Corvan et al. (2026) conducted a case report in IVUS catheter entrapment during PCI for non-ST elevation acute coronary syndrome (n=1). Percutaneous retrieval by balloon trapping and pull-back method was evaluated on Successful retrieval of trapped IVUS catheter. A trapped IVUS catheter in the Left Main Stem during complex PCI was successfully retrieved using a balloon trapping and pull-back method.
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