# Successful Retrieval of a Torn KUSABI Trapping Balloon Catheter From the Coronary Artery and Verification of the Reproducibility of Trapping Balloon Catheter Shaft Tears

## TL;DR

A torn KUSABI balloon catheter was retrieved from a patient's artery, and the cause of the tear was investigated to improve future procedures.

## Contribution

The study identifies the cause of a rare KUSABI balloon catheter tear and provides practical recommendations for safe retrieval.

## Key findings

- The tear was likely caused by excessive force during removal at 14 atm inflation pressure.
- Twisted wires were not involved in the balloon tearing.
- Proper deflation before retrieval is recommended to prevent such incidents.

## Abstract

The balloon trapping technique is frequently used during percutaneous coronary intervention, which is a common treatment for ischemic heart disease. A 68-year-old man with induced ischemia, stenotic lesions, and arterial calcifications underwent catheterization of the circumflex artery and debulking of lesions. During the removal of the catheter, the tip of the balloon catheter used in the procedure dislodged and entered the circumflex artery. After successfully retrieving the catheter, we conducted a bench test of the balloon catheter to determine the cause of the tear. The results suggested that the tearing of the KUSABI balloon might have been caused by manual pulling of the shaft quickly at an inflation pressure of 14 atm and that twisted wires were not involved in balloon tearing. The tensile strength of the balloon catheter was 5N. We believe that the balloon tore owing to excessive force applied to dislodge the tip and because the trapping balloons were not properly deflated. As KUSABI trapping balloons have had a rupture rate of just 0.003% since their launch in 2013, we recommend paying attention to KUSABI balloon deflation within the guiding catheter before its retrieval in order to ensure that only a gentle pull is needed. If resistance is felt during the removal of the KUSABI balloon, it should be confirmed that the tip is in place after removing it.