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Erroneous Rapid Exchange Balloon Inflation During Coronary Angioplasty in a Male Patient in His 70s With Chronic Stable Angina

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1 Credit CME

A male patient aged 73 years with a history of type 2 diabetes and hypertension was found to have a mid–right coronary artery (RCA) lesion on coronary angiography. As a result, the patient was wired with a workhorse 0.14” coronary guidewire, and a rapid exchange balloon (2.75 × 12 mm) was tracked to the lesion. When the balloon was inflated, 2 dilatations were noted (Figure, A). The patient developed proximal RCA dissection and sudden clinical and hemodynamic deterioration. As a result, the patient required stent placement with 2 overlapping stents using intravascular ultrasonography guidance. The erroneous inflation was probably due to improper gluing of the proximal end of the balloon to the shaft (Figure, B). Coronary balloon-related complications like rupture and entrapment have been described in the literature, but dilatation of the glued part of the balloon has not, to our knowledge, been reported.1,2

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Article Information

Published Online: August 30, 2023. doi:10.1001/jamacardio.2023.2658

Corresponding Author: Saurabh Ajit Deshpande, DM, Department of Cardiovascular and Thoracic Surgery, Jagjivan Ram Western Railway Hospital, RBI Colony, MM Marg, Mumbai Central, Mumbai 400008, Maharashtra, India (saurabhmddm@gmail.com).

Conflict of Interest Disclosures: None reported.

References
1.
Trivedi  R .  Double jeopardy: failure to deflate stent balloon in rescue angioplasty.   Interv Med Appl Sci. 2019;11(2):128-130. doi:10.1556/1646.11.2019.16PubMedGoogle ScholarCrossref
2.
Sofidis  G , Kartas  A , Karagiannidis  E , Stalikas  N , Sianos  G .  A case of balloon rupture during coronary angioplasty: slow flow requiring swift action.   Cureus. 2020;12(7):e9335. doi:10.7759/cureus.9335PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME [and Self-Assessment requirements] of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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