The feasibility of a novel method to remove circumferentially ruptured balloons during ultrasound-guided percutaneous transluminal angioplasty for arteriovenous dialysis access

Abstract

Objective: Angioplasty balloon rupture is a rare complication during percutaneous transluminal angioplasty (PTA). Conventional approach to retrieve circumferentially ruptured balloons is open surgery. This study examined the feasibility of a novel approach which can remove ruptured balloon during PTA in vascular access. Methods: This retrospective study analyzed 35 patients of a total 6465 patients that underwent ultrasound-guided PTA with a circumferential balloon rupture from February 2016 and August 2023. The patients underwent surgery (Group I, n = 13) or the novel method (Group II, n = 22) for balloon retrieval. Kaplan–Meier curve was used to assess the primary patency rates of the two groups. Result: The total incidence of circumferential balloon rupture was 0.5% in our center. Balloon retrieval was successful in both groups with no complications except one case had an infection in the surgical wound. Kaplan–Meier curve analysis showed that the post-intervention primary patency rates of the two methods were not significantly different ( p > 0.05). There was a significant difference between pre-operation and post-operation brachial arterial flow ( p < 0.001). Conclusion: The feasibility of the novel technique for retrieval of circumferential ruptured balloons during ultrasound-guided PTA is validated. The technique enables less invasive retrieval and continuation of PTA.