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. 2025 Aug 20;30(24):104668.
doi: 10.1016/j.jaccas.2025.104668.

Balloon-Assisted Traction Removal of a Fractured Catheter in the Distal Tibial Artery

Kun Wang  1 , Yuan Yao  1 , Zhe-Jing Ding  1 , Heng Zhang  1 , Gui-de Liu  1 , Ji-Yan Chen  2 , Xiao-Fei Jiang  3
Affiliations

Balloon-Assisted Traction Removal of a Fractured Catheter in the Distal Tibial Artery

Kun Wang et al. JACC Case Rep. .

Abstract

Objective: A patient with fractured catheter in the distal tibial artery was successfully retrieved using balloon-assisted traction.

Key steps: 1) Detect the fracture and dislodgement of the catheter; 2) under fluoroscopy, identify the route of dislodgement; 3) confirming the catheter had dislodged into the right lower limb, perform arterial angiography via puncture of a contralateral artery; 4) advance a guidewire through the fractured catheter, traversing its midsection to the distal end; 5) pass 1.5-mm Maverick2 balloon over the catheter and inflate it to 16 atm; and 6) secure and carefully retrieve the catheter.

Potential pitfalls: In high-humidity regions, the storage conditions of catheters must be strictly controlled. Moreover, the fragility of catheters should be thoroughly assessed in vitro prior to surgery to minimize the risk of vascular embolism and ischemia.

Take-home message: Balloon capture of the fractured catheter can be considered an effective method for removing fractured catheters in the distal and small arteries.

Keywords: balloon-assisted traction; fractured catheter; interventional therapy; tibial artery.

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Conflict of interest statement

Funding Support and Author Disclosures The article was supported by “The Guangdong-Macau Youth Talent Two-way Exchange Program” (Grand number: 207145746053). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
The Details of the Catheter (A) The information of the 5F vertebral catheter. The red arrow indicated the validity period is July 20, 2026. (B) The catheter was easily fractured outside the body. The red arrows indicated the fractured catheter.
Figure 2
Figure 2
The Image During the Procedure (A) The tip of the catheter fractured in the left pulmonary vein. (B) The tip of the catheter fractured migrated into the left ventricle. (C) The fractured catheter was founded in the right lower limb. (D) The fractured catheter was confirmed in the right distal tibial artery by the arterial angiography. (E) The guidewire passing through the middle part of the fractured catheter to its distal end. (F) The balloon was passed over the catheter and inflated. (G) The fractured catheter was carefully retrieved. (H) The scan of the lower limb arteries without stenosis or injury. The red-colored arrows indicated the fractured catheter.
See this image and copyright information in PMC