Key result
Intravascular lithotripsy balloon entrapment during calcified RCA intervention requires emergency CABG bailout.
Why the study?
Entrapment of intravascular lithotripsy balloons during PCI is a rare complication with limited reported cases requiring surgical bailout.
Case Report (n=1)
During intravascular lithotripsy, resistance to crossing should prompt immediate reassessment of the calcium modification strategy rather than forceful advancement to avoid balloon entrapment requiring surgical bailout.
Answers are grounded in this paper and cite their sources.
IVL balloon entrapment may require surgical bailout; case report leaves open optimal retrieval strategies in calcified lesions.
BACKGROUND: A clinical case of an entrapped intravascular lithotripsy (IVL) balloon, requiring surgical bailout. CASE SUMMARY: A 72-year-old gentleman presented with a non-ST-segment elevation myocardial infarction. A severe mid right coronary artery calcific lesion was the culprit. We attempted to treat this with percutaneous coronary intervention using IVL. After completion of IVL therapy, the balloon was unable to be freed. All strategies to free the balloon were unsuccessful (a 3-wire wrap, inflating a balloon in parallel and snaring). The patient was sent for emergency coronary artery bypass graft surgery. The IVL balloon could not be freed by the surgeon and so was left cut at the ostium. DISCUSSION: To our knowledge, this is the only such case report highlighting an entrapped IVL balloon, requiring surgical bailout. TAKE-HOME MESSAGE: Our learning from this case is that when using IVL, resistance to crossing should prompt reassessment of calcium modification strategy rather than continued forceful advancement.
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Sharma et al. (2026) conducted a case report in Non-ST-segment elevation myocardial infarction with severe coronary artery calcification (n=1). Intravascular lithotripsy was evaluated. An intravascular lithotripsy balloon used in a 72-year-old man with a severely calcified right coronary artery became irreversibly entrapped, requiring emergency coronary artery bypass graft surgery.
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