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Trapping as retrieval technique to resolve a ruptured and entrapped coronary balloon catheter

A 69 year old male, with a previous percutaneous revascularization of the mid‐circumflex with a bare metal stent in 2007 was admitted to our centre for unstable angina. The angiography showed a severely calcified coronary tree with a functionally severe plaque on the proximal left anterior descending artery (LAD) and a critical focal lesion on the proximal right coronary artery. After a high pressure predilation on the proximal LAD, the balloon ruptured causing a retrograde LAD‐left main (LM) dissection that was rapidly sealed with three overlapping zotarolimus‐eluting stents from medial LAD to LM. We then used a new non‐compliant balloon for successive aggressive postdilation. After a difficult handling, when the balloon catheter was pulled out of the body and we realized that the tip and membranous part of the balloon‐catheter was separated from the rest, and entangled at the LM. After a first approach to retrieve the dislodged balloon with a snare, the ruptured balloon was successfully removed by trapping and withdrawing the whole system, including the guiding catheter and the wire.