Key result
Percutaneous snaring and needle decompression rescue an entrapped pericardiotomy balloon, avoiding surgical bailout.
Why the study?
Balloon rupture and entrapment during percutaneous balloon pericardiotomy is rare and usually requires surgical intervention, though various percutaneous bailout techniques can be attempted.
Case Report (n=1)
This case demonstrates that a ruptured and entrapped balloon during percutaneous balloon pericardiotomy can be successfully retrieved percutaneously using a snare and needle decompression, avoiding surgery.
May enable percutaneous bailout for balloon entrapment in PBP; leaves open reproducibility beyond this first reported case.
Background Balloon rupture and entrapment during percutaneous balloon pericardiotomy (PBP) is rare and usually requires surgical intervention. However, various bailout techniques can be tried. We describe a case of balloon entrapment in the pericardium and the strategies employed to successfully remove the balloon percutaneously. Case summary A 58-year-old woman presented with recurrent malignant pericardial effusion (MPE). She refused surgery and opted for PBP. During the procedure, the balloon ruptured and was trapped within the pericardium. The entrapped balloon was secured by snaring onto the proximal end of the balloon. The distal end of the balloon remained trapped across the pericardium as it did not deflate completely after rupturing. Therefore, a needle was inserted under fluoroscopic guidance decompress the balloon, which enabled its successful removal percutaneously. Discussion This is the first reported case of balloon rupture and entrapment during PBP that was successfully removed percutaneously. When balloon rupture and entrapment occur, retrieval can be attempted by using forceps and snares.
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Wong et al. (2026) conducted a case report in Recurrent malignant pericardial effusion (n=1). Percutaneous balloon pericardiotomy and percutaneous balloon retrieval was evaluated. An entrapped, ruptured balloon during percutaneous balloon pericardiotomy was successfully retrieved percutaneously using a snare and needle decompression, avoiding surgical bailout.
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