Balloon Rupture Research Articles

Orbital wall restoration with primary bone fragments in complex orbital fractures.

Complex orbital fractures are impure orbital fractures because they involve the orbital walls and mid-facial bones. The author reported an orbital wall restoration technique in which the primary orbital wall fragments were restored to their prior position in complex orbital fractures in 2020. As a follow-up to a previous preliminary study, this study retrospectively reviewed the surgical results of complex orbital wall fractures over a 4-year period and compared the surgical outcomes by dividing them into groups with and without balloon restoration. Data of 939 patients with facial bone fractures between August 2018 and August 2022 were reviewed. Of these, 154 had complex orbital fractures. Among them, 44 and 110 underwent reduction with and without the balloon technique respectively. Pre- and postoperative Naugle exophthalmometer (Good-Lite Co.) scales were evaluated. The orbital volume and orbital volume ratio were calculated from preoperative and 6 months postoperative computed tomography images. Among 154 patients with complex orbital fractures, 44 patients underwent restoration with the balloon technique, and 110 patients underwent restoration without it. The Naugle scale did not differ significantly between the two groups, but the orbital volume ratio significantly decreased by 3.32% and 2.39% in groups with and without the balloon technique and the difference in OVR was significantly greater in patients in the balloon restoration group compared with the control group. Postoperative balloon rupture occurred in six out of 44 cases (13.64%). None of the six patients with balloon rupture showed significant enophthalmos at 6 months of follow-up. The balloon rupture rate was 13.64% (6/44 cases) with marginal screw fixation, blunt screws, and extra protection with a resorbable foam dressing. Furthermore, we restored the orbital wall with primary orbital fragments using balloon support in complex orbital wall fractures.

Failure to post-dilate BeSmooth peripheral stents to adult vessel size diameters during benchside tests

Low-profile stent implantation remains a rescue treatment for aortic coarctation and branch pulmonary arteries stenosis in small children. Stent re-expansion to cope with vascular growth remains problematic. To evaluate ex vivo feasibility and mechanical behaviour of over-dilating BeSmooth peripheral stents (Bentley InnoMed, Germany). Three BeSmooth peripheral stents in diameters of 7, 8, and 10 mm were dilated to nominal pressure and then 13 atm. BeSmooth Ø7 × 23 mm was sequentially post-dilated using 12, 14, and 16 mm high-pressure balloons. BeSmooth Ø10 × 57 mm was post-dilated with a 14 mm balloon and then with a 48 mm bare-metal Optimus XXL stent hand-mounted on a 14 mm balloon (stent-in-stent). BeSmooth Ø8 × 57 mm was directly post-dilated with a 48 mm bare-metal Optimus XXL stent hand-mounted on a 16 mm balloon (stent-in-stent). The stents' diameter and length were measured. Digital inflation pressure was noted. Balloon rupture and stent fracture patterns were closely evaluated. At 20atm pressure, BeSmooth Ø7 × 23 mm shortened to 2 mm forming a 12 mm diameter solid ring circle and the woven balloon ruptured radially. At 10 atm pressure, BeSmooth Ø10 × 57 mm fractured longitudinally in various dispatched breaking points at a diameter of 13 mm without shortening and ruptured the balloon with multiple pinholes. At 10 atm pressure, BeSmooth Ø8 × 57 mm fractured centrally at three different points at a diameter of 11.5 mm without shortening and the balloon broke radially in half. In our benchmark tests, extreme shortening, severe balloon rupture, or unpredictable stent fracture patterns at small balloon diameters limits safe post-dilation of BeSmooth stents beyond 13 mm. BeSmooth stents are not ideal candidates for off-label stent interventions in smaller patients.

Fetal cardiac interventions: First‐year experience of a tertiary referral center in Turkey

To present the first-year experience of fetal cardiac interventions (FCIs) in a tertiary referral hospital and to evaluate the outcomes. This retrospective study consisted of four pregnant women who underwent fetal pulmonary or aortic balloon valvuloplasty between November 2020 and June 2021. The procedures were performed with a percutaneous cardiac puncture under the ultrasonography guidance. Gestational age at intervention, procedural success, complications, and perinatal outcomes were evaluated. Procedural complications defined as fetal bradyarrhythmia requiring treatment, pericardial effusion requiring drainage, balloon rupture, and fetal death. The procedure was considered technically successful if the valve was dilated with a balloon catheter. Ultimately successful procedure was defined as the discharge of infants alive with biventricular circulation. A total of 5 FCIs attempted between 26 + 3 and 28 + 2 gestational weeks. While the procedure was technically successful in 2 cases with pulmonary stenosis, both attempts were unsuccessful in the fetus with pulmonary atresia. Although the procedure was technically successful in the patient with critical aortic stenosis, it ultimately failed. No fetal death occurred in our series and there were no procedure-related significant maternal complications. However, three interventions were complicated by fetal bradycardia and pericardial effusion necessitating treatment, and balloon rupture cropped up in one case. FCIs may lead to improving the likelihood of a biventricular outcome for selected fetuses. Careful selection of patients and centralization of experience are essential for obtaining favorable outcomes. Operators should be aware of procedural complications. Improved procedural techniques with a lower complication rate will be achieved through advanced medical technology and special balloon catheters.

TCTAP C-128 A Case of Calcified RCA Complicated With Balloon Rupture and Trapped Balloon

TCTAP C-128 A Case of Calcified RCA Complicated With Balloon Rupture and Trapped Balloon

TCTAP C-099 Double Trouble ! Coronary Dissection by Balloon Rupture Followed by Stuck IVUS After Stenting in a Rotational Atherectomy Case

TCTAP C-099 Double Trouble ! Coronary Dissection by Balloon Rupture Followed by Stuck IVUS After Stenting in a Rotational Atherectomy Case

TCTAP C-105 A 'Tsunami' Consequence of Intravascular Lithotripsy Balloon Rupture - Extensive Coronary Artery Dissection With Intramural Hematoma

TCTAP C-105 A 'Tsunami' Consequence of Intravascular Lithotripsy Balloon Rupture - Extensive Coronary Artery Dissection With Intramural Hematoma

Balloon Catheter Technique for Prevention of Vascular Injuries During Arthroscopic Posterior Cruciate Ligament Reconstruction

Arthroscopic posterior cruciate ligament (PCL) reconstruction is a technically demanding procedure and is associated with several intraoperative and postoperative complications, although less-common but intraoperative iatrogenic popliteal artery injuries have been reported. At our center, we developed a simple and effective technique using a Foley balloon catheter that ensures a safe surgery to avoid possible neurovascular complications. Through a lower posteromedial portal, this inflated balloon acts as protective mechanism between the PCL and posterior capsule. Betadine or methylene blue dye is used to inflate this bulb, which provides easy identification if balloon ruptures, as evidenced by leakage of this solution in posterior compartment. This balloon increases significant distance, equivalent to the diameter of the balloon, between the PCL and popliteal artery by pushing the capsule more posteriorly. This balloon catheter protection technique combined with other methods will ensure a greater level of safety when performing an anatomical PCL reconstruction.

Balloon Rupture during Pre-Dilation for Transcatheter Aortic Valve Replacement in Patients with a Bicuspid Aortic Valve: Classification, Treatment Strategies, and Prevention

Balloon rupture during transcatheter aortic valve replacement (TAVR) is a rare but serious complication. Here, we present two cases of balloon rupture in patients with severe aortic stenosis and type 0 bicuspid aortic valves. Three-dimensional models based on pre-procedure cardiac CT angiography were used to investigate these cases post hoc. The models revealed asymmetrical distribution of calcifications with sharply spiked features in the bicuspid aortic valves. The narrow calcified orifices resulted in uneven force distribution on the expanded balloon, thus leading to balloon rupture. We additionally review the classification and causes of balloon rupture, summarize methods for avoiding complications, and describe treatment options. Accurate pre-procedural anatomy evaluation and computer modeling are crucial for planning and managing TAVR procedures. Further investigation through computer simulation is necessary to determine the appropriate balloon size and inflation locations, to provide a reference for pre-procedural preparation.

Balloon-expandable stents for native coarctation of the aorta in children and adolescents.

Although balloon-expandable stent implantation for native aortic coarctation is a preferred method in the adolescent age group, there are insufficient data about indications for and the efficacy of the procedure in a younger age group. The aim of this study was to compare and evaluate the data of young pediatric and adolescent patients who underwent balloon-expandable stent implantation because of native aortic coarctation. The retrospective analysis included the demographic characteristics and data related to the procedure and follow-up of patients who underwent stent implantation for native aortic coarctation between August 2010 and November 2017. Patients with re-coarctation were excluded from the study. The patients were separated into 2 groups as the adolescent group (Group I: 10-18 years) and the pediatric group (Group II: ≤ 9.9 years). Group-I comprised of 18 patients and Group-II, 32 patients. Covered stent was implanted to 32 (73%) patients and uncovered stent to 12 (27%) patients. The procedural success rate was 100%. Following stent implantation, peak systolic gradient decreased significantly in both groups (P < .0001) (Group-I: from 35.9 ± 16.6 mm Hg-2.2 ± 3.4 mm Hg, Group II: from 34 ± 13.3 mm Hg-3 ± 4.09 mm Hg). Complications developed in 3 patients, and all in Group I. Femoral hematoma developed in 1 patient, balloon rupture occurred during the procedure in 1 patient, and there was temporary loss of pulse in 1 patient. All the complications were treated successfully. All the patients were taking anti-hypertensive drugs before intervention and during the mean 23-month follow-up period (range, 2-84 months), hypertension recovered in 35 (80%) patients and drugs were terminated. Stent implantation for aortic coarctation in the pediatric age group may provide pleasing results, reducing the coarctation gradient, providing effective dilatation in the lesion area and eliminating hypertension.

846: IS TRANSTRACHEAL POCUS HELPFUL IN DETERMINING ENDOTRACHEAL TUBE POSITION? A RANDOMIZED CONTROL TRIAL

Introduction: Endotracheal tube (ETT) malposition is associated with adverse events. Chest x-ray (CXR) is the gold standard modality for determining ETT position and depth in the trachea. However, Point-of-Care Ultrasound (POCUS) has emerged as a novel non-invasive alternative. We aimed to determine if an integrated protocol employing both transtracheal ultrasound and CXR for identifying ETT malposition in the trachea, compared to CXR alone, would result in fewer adverse events. Methods: We performed a single-center randomized control trial of intubated patients in a multidisciplinary intensive care unit at an academic hospital. Intubated patients were randomized into two arms: POCUS integrated or CXR alone daily ETT monitoring. In both arms, trained sonographers assessed for ETT position and related adverse events: migration into bronchus, herniation into vocal cords, balloon rupture, unplanned extubation, and aspiration pneumonia. In the POCUS integrated arm, the ICU rounding team was provided with the sonographer’s findings to aid in clinical decision making. A Pearson’s Chi-Squared test was used to compare the results between the two arms. Results: A total of 76 patients amounting to 187 ventilator days were randomized to receive either POCUS integrated (91 ventilator days) or CXR alone (96 ventilator days) daily ETT monitoring. The average patient age was 57.8 years +/- 17.0 years. Most patients were intubated for airway protection (46.1%) and hypoxic respiratory failure (40.8%). There were 10 adverse events recorded (7 aspiration pneumonias, 1 herniation through the vocal cords, 2 migration into a bronchus) out of 187 ventilator days. There was a trend toward lower adverse events in the POCUS integrated group compared to the CXR alone group (2.2% vs. 8.3%; p=0.062, respectively). Furthermore, the ETT depth was adjusted more frequently in the POCUS integrated group compared to the CXR alone group; however, this was not statistically significant (7.7% vs. 3.1%; p=0.165, respectively). Conclusions: Based on our data, the integrated protocol employing transtracheal ultrasound and CXR did not result in fewer adverse events than CXR alone. However, there was a trend toward less adverse events with the integrated protocol, and further investigations with larger sample sizes are needed.

Myocardial infarction with nonobstructive coronary arteries in a woman: Takotsubo cardiomyopathy or true myocardial infarction?

Myocardial infarction with nonobstructive coronary arteries in a woman: Takotsubo cardiomyopathy or true myocardial infarction?

Superficial Femoral Artery Rupture "Bailed Out" Using Novel Design of Supera Stent.

Peripheral artery disease is a condition that occurs due to narrowing or occlusion of arterial lumen usually secondary to atherosclerosis. Endovascular treatments are minimally invasive procedures that have become popular for recanalization of such calcified/sclerosed arteries. However, heavily calcified arteries make these procedures challenging and are more prone to complications like balloon rupture and bleeding. Herein, we report a novel case of rupture of superficial femoral artery and its management using self-expanding Supera stent.

Cushioned on the way up, controlled on the way down during resuscitative endovascular balloon occlusion of the aorta (REBOA): investigating a novel compliant balloon design for optimizing safe overinflation combined with partial REBOA ability

BackgroundThere are a variety of devices capable of performing resuscitative endovascular balloon occlusion of the aorta (REBOA), with most containing compliant balloon material. While compliant material is ideal for balloon...

Fully Percutaneous Retrieval of Delivery System After Balloon Rupture During Trans-Catheter Aortic Valve-in-Valve Implantation

Fully Percutaneous Retrieval of Delivery System After Balloon Rupture During Trans-Catheter Aortic Valve-in-Valve Implantation

Safety and efficacy of the SeparGateTM balloon-guiding catheter in neurointerventional surgery: A prospective, multicenter, single-arm clinical trial

ObjectiveTo evaluate the safety and efficacy of the SeparGate™ balloon-guiding catheter (BGC) for blocking flow and delivering devices in neurointerventional surgery. MethodThis prospective multicenter single-arm trial enrolled patients who received BGC adjuvant therapy to provide temporary blood flow arrest of the supra-aortic arch arteries and their branch vessels in interventional therapy. The primary endpoint was immediate procedural success rate in flow arrest, device delivery, and withdrawal. The efficacy endpoints were intraoperative product performance, including rigidity, smoothness, fracture resistance of the catheter wall, catheter push performance, compatibility and radiopaque display, integrity, adhesion thrombus after withdrawal and balloon rupture. The safety endpoints were adverse and serious adverse events associated with the test device and serious adverse events resulting in death or serious health deterioration. ResultA total of 129 patients were included; of them, 128 were analyzed in the full analysis set (FAS) and per protocol set (PPS). Immediate procedural success was achieved in 97.7% of patients with FAS and PPS. The lower bound of the 95% confidence interval was 94.6%, higher than the preset efficacy margin of 94%. Device-related adverse events occurred in 2 (1.6%) cases. One was mild adverse event of vasospasm, which resolved spontaneously. The other was serious adverse event of dissection aggravation, which was treated with stenting angioplasty. No device defects were observed. ConclusionIn neurointerventional surgery, the SeparGate™ BGC can be used to temporarily block the flow of the supra-aortic arch arteries and their branch vessels and guide the interventional device to the target vascular position.

Learning curve for laser balloon ablation in the treatment of atrial fibrillation: a single center experience

Abstract Funding Acknowledgements Type of funding sources: None. Background Visually guided laser balloon ablation (LBA) is a promising method for pulmonary vein (PV) isolation in the treatment of atrial fibrillation (AF). To reduce procedural times, the rapid mode feature (RM), which offers an automated continuous 360° lesion for pulmonary vein isolation, was implemented in the latest version of the laser balloon system. Purpose We evaluated the learning curve for LBA in the treatment of AF Method We enrolled the first 74 patients with paroxysmal or persistent AF treated with LBA in our centre between September 2020 and December 2021. Exclusion criteria were any contraindication for the procedure. 3 different time intervals were considered (time 1 T1, time 2 T2 and time 3 T3), which included the first 25 patients, the next 25 patients and the last 24 patients, respectively. We compared fluoroscopy and procedural time and the number of pulmonary veins isolated by RM &amp;gt;90% (&amp;gt;324°) among the three group were compared. Results There was no difference between the three intervals in terms of age (61.2 ±9.00 vs 63.9 ±11.4 vs 58.4 ±12.9; p=n.s.), sex (68% vs 64% vs 81%; p=n.s.) and clinical characteristics. The procedural time (see picture 1) was significantly reduced from T1 to T2 (199 ±51.8 in T1 vs 159 ±38.6 in T2; p&amp;lt; 0.01), while there was no variation between T2 and T3 (159 ±38.6 in T2 vs 153 ±51.9 in T3; p=n.s.). We detected a reduction in fluoroscopy time between T1 and T2 (38.8 ±15.2 in T1 vs 28.8 ±10.5 in T2; p&amp;lt;0.01) but not further reduction was observed between T2 and T3 (28.8 ±10.5 in T2 vs 30.5 ±16.7 in T3; p =n.s.). Considering the use of (RM) feature, there was a progressive increase in the number of PVs isolated by RM &amp;gt;90% over time (1.0 ±0.7 PVs in T1 vs 2.0 ±1.2 PVs in T2 vs 3.3 ±0.9 in T3: p &amp;lt;0.01). Five pinhole balloon ruptures were observed, three in the T1 group, two in the T3 group. Temporary phrenic nerve dysfunction occurred in 1 patient in the T3 interval. No other complications were reported. Conclusions PV isolation by visually guided LBA is a safe procedure even during the learning curve. The system is user friendly and procedural time and fluoroscopy time reduced after a limited number of procedures.

Rapid mode in novel generation visually guided laser balloon system: feasibility, safety, and impact on procedural outcomes

Abstract Funding Acknowledgements Type of funding sources: None. Background Laser balloon (LB) systems are increasingly used for pulmonary vein isolation (PVI) in catheter ablation of atrial fibrillation (AF). The novel generation of the visually guided LB system includes a rapid mode (RM) feature, which potentially allows a continuous circumferential lesion for PVI. Nevertheless, data on its practicability and on its impact on procedural outcomes are lacking. Purpose To analyse the applicability of RM and its effect on procedural and fluoroscopic time in a cohort of patients who underwent catheter ablation of AF using a LB system. Methods Between September 2020 and December 2021, we prospectively included all consecutive patients who underwent PVI with LB at our centre. All the procedures were performed by the same two operators. For each pulmonary vein (PV), we firstly attempted to obtain a complete circumferential lesion at 13 W using the RM. If its application was not possible or incomplete, we performed additional single lesions at 5.5, 8.5 or 13 W to achieve complete visual PVI. Finally, we calculated the percentage of singular and total circumferential lesions made with RM for every procedure and evaluated its influence on procedural outcomes. Results 75 patients were enrolled. We identified and successfully isolated 289 PVs, with mean procedural and fluoroscopic time of 171±51 and 38±15 min, respectively. Use of RM for more than 70% of the circumferential lesion was possible in 185 veins (64%), while we obtained complete isolation using only RM in 90 veins (31%). Reasons for interruption of RM were unfavourable anatomy, imperfect visualization of the ostium of the PV and presence of blood between the balloon and the anatomic substrate. For each vein, we observed a significantly shorter ablation (13±8 vs 23±12 min, p&amp;lt;0.001) and fluoroscopic time (3±3 vs 5±4 min, p&amp;lt;0.01) if &amp;gt;70% of the circumferential lesion was made through RM. Further, total procedural (157 ±52 vs 192±42 min, p&amp;lt;0.01), ablation (53±17 vs 88±27, p &amp;gt;0.001) and fluoroscopic time (30±15 vs 36.9±14 min, p 0.025) were significantly shorter if more than 70% of total circumferential lesion was achieved through rapid mode. There were five pinhole balloon ruptures during application of RM. No major complication occurred. Conclusions RM is a novel feature in the latest generation of LB system. In our cohort, it showed good applicability and safety, while significantly reducing procedural times. Further studies are needed to understand its possible impact on clinical outcomes.

Combination of Preoperative Multimodal Image Fusion and Intraoperative Dyna CT in Percutaneous Balloon Compression of Trigeminal Ganglion for Primary Trigeminal Neuralgia: Experience in 24 Patients.

ObjectiveWe retrospectively assessed the surgical results of PBC with preoperative multimodal image fusion and intraoperative Dyna Computed Tomography (CT) in 24 patients with primary trigeminal neuralgia (PTN) to explore a valuable aid for Percutaneous balloon compression (PBC).MethodsWe studied the data of 24 patients with PTN. All patients underwent PBC and were assessed with preoperative multimodal image fusion [computed tomography (CT) and magnetic resonance imaging (MRI)] and intraoperative Dyna CT in the Department of Neurosurgery of Zhuhai People’s Hospital between October 2020 and September 2021. Multimodal image fusion—three-dimensional (3D) reconstruction of CT and MRI data—was performed using 3D-Slicer software, and preoperative evaluation was performed according to the results of image fusion. Dyna CT was used to dynamically observe the position and shape of the metallic hollow introducer and Fogarty catheter and balloon during the operation to guide the operation in real time. We performed follow-up assessments each month and summarized the clinical characteristics, surgical effects, and complications in all patients.ResultsSurgery was successful for all patients; the patients reported immediate pain relief. Surgical complications included facial numbness in 24 patients (100%), mild masseter weakness in three (12.5%), herpes zoster in three (12.5%), and balloon rupture in one (4.2%). None of the patients had serious surgical complications. The mean follow-up time was 9.6 ± 2.7 months. During the follow-up period, 22 patients (91.7%) experienced no recurrence of pain, and two patients (8.3%) experienced recurrence of pain, of which one underwent secondary PBC surgery.ConclusionsPreoperative multimodal image reconstruction can help fully evaluate PBC surgery, clarify the etiology, and predict the volume of contrast medium required during the operation. It provided important assistance for PBC treatment of trigeminal neuralgia patients when preoperative multimodal image fusion is combined with intraoperative Dyna CT.

MP16-06 FOLEY CATHETER BALLOON RUPTURE AND RISK OF FREE FRAGMENT FORMATION

You have accessJournal of UrologyCME1 May 2022MP16-06 FOLEY CATHETER BALLOON RUPTURE AND RISK OF FREE FRAGMENT FORMATION Jason L. Lui, Nathan M. Shaw, Nizar Hakam, Behnam Nabavizadeh, Behzad Abassi, Patrick Low, Kevin D. Li, and Benjamin N. Breyer Jason L. LuiJason L. Lui More articles by this author , Nathan M. ShawNathan M. Shaw More articles by this author , Nizar HakamNizar Hakam More articles by this author , Behnam NabavizadehBehnam Nabavizadeh More articles by this author , Behzad AbassiBehzad Abassi More articles by this author , Patrick LowPatrick Low More articles by this author , Kevin D. LiKevin D. Li More articles by this author , and Benjamin N. BreyerBenjamin N. Breyer More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002549.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Indwelling urinary catheters allow for short and long-term drainage of the bladder and are crucial to urologic care. There is a paucity of data regarding the risk of catheter balloon rupture and factors associated with balloon rupture and fragmentation are poorly defined. Catheter balloon fragmentation is of crucial clinical importance as it can serve as a nidus for stone formation and/or infection. We aimed to assess the volume of foley catheter balloon rupture and incidence of free fragment formation and to provide guidance through clinical scenarios on the management of overinflation. METHODS: A total of 85 foley catheters (45 latex catheters and 40 all-Silicone) were used. These were separated into sets of 5 or 10 identical catheters across common sizes, including 14, 16, and 18 French (fr), and inflated sequentially with 10mL of sterile water in an aqueous environment without positive pressure. Catheters were monitored for rupture and fragmentation. The number of catheters producing free fragments and fragment size was recorded. The maximum instilled volume prior to rupture (“burst volume”) was recorded. An additional subset of catheters were inflated to recommended balloon volume and the balloon was then punctured with needle. RESULTS: Of the 35 latex catheters, 27 (77.1%) produced a free fragment during spontaneous rupture. Fragments ranged from 2.1cm to 3.1cm with a standard deviation of 0.31. Latex catheters had average burst volume of 83, 90, and 112, and 202mL for 14Fr, 16Fr, 18Fr, and 16Fr 3-Way, respectively. Of the 30 silicone catheters, no fragments were noted from spontaneous rupture. The average burst volume for silicone catheters was 57, 45, and 55mL for 14Fr, 16Fr, and 18Fr, respectively. The latex and silicone catheters inflated to recommended volumes and ruptured did not produce fragments. CONCLUSIONS: All catheters can be inflated to higher volumes than the manufacturer recommendation, with latex catheters having a high likelihood (>75%) of releasing fragments at peak volumes. At normal fill volumes, needle puncture does not generate fragments. Source of Funding: Kevan and Anita Del Grande © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e276 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jason L. Lui More articles by this author Nathan M. Shaw More articles by this author Nizar Hakam More articles by this author Behnam Nabavizadeh More articles by this author Behzad Abassi More articles by this author Patrick Low More articles by this author Kevin D. Li More articles by this author Benjamin N. Breyer More articles by this author Expand All Advertisement PDF DownloadLoading ...

Foley Catheter Balloon Rupture and Risk of Free Fragment Formation

ObjectivesTo assess the volume of foley catheter balloon rupture and the incidence of free fragment formation. Materials and MethodsForty Latex and 30 Silicone catheters of common sizes (14-20 French) were inflated with sterile water in an aqueous environment without positive pressure. Catheters producing fragments, fragment size, and maximum instilled volume prior to rupture (“burst volume”) were recorded. A subset of catheters was inflated to recommended balloon volume and the balloon was needle punctured. ResultsOf the 40 latex catheters, 32 (80%) produced a free fragment during spontaneous rupture. Fragments ranged from 2.1 to 3.2 cm with an average size of 2.74 ± 0.33 cm. Latex catheters had average burst volume of 83 mL, 90 mL, 112 mL,120 mL, and 422 mL for 14 Fr, 16 Fr, 18 Fr, 16 Fr 3-way, and 20 Fr 30 cc, respectively. Of the 30 silicone catheters, spontaneous rupture produced no fragments. Average burst volume for silicone catheters was 57 mL, 45 mL, and 55 mL for 14 Fr, 16 Fr, and 18 Fr, respectively. No catheter balloons produced fragments when needle punctures at recommended balloon volumes. ConclusionLatex catheter balloons tolerate higher fill volumes but have a high likelihood of releasing fragments. Silicone catheters burst at lower volumes, but do not release fragments. At normal fill volumes, needle puncture is safe, and cystoscopy is likely unnecessary.