Intravascular Lithotripsy Balloon Entrapped in Right Coronary Artery Requiring Surgical Bailout.

Authors

Pranev Sharma, Helen Routledge, Jasper Trevelyan

Published in

JACC. Case reports. Pages 110448. Sep 24, 2026. Epub Sep 24, 2026.

Abstract

A clinical case of an entrapped intravascular lithotripsy (IVL) balloon, requiring surgical bailout.
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.
To our knowledge, this is the only such case report highlighting an entrapped IVL balloon, requiring surgical bailout.
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.

PMID:
42788913
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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