Incident description: upon doing percutaneous transluminal angioplasty (pta) on patient's right superficial femoral artery (sfa), the drug-eluting balloon appeared to be losing atmospheres of pressure due to possible leakage of balloon.The dwell time for this balloon is 3 minutes at 8 atms, but after 2 minutes, all solution in inflation device was gone, so we had to disconnect inflation device, refill w/saline contrast mixture and re-inflate.Then i noticed the device was leaking out of the proximal end of balloon catheter at the junction between the clear y-connector and the blue catheter shaft on the proximal end.No harm was done to patient.No other balloons or devices used.Results of procedure were good.Procedural note: procedure in detail: we engaged the right common iliac artery with a diagnostic internal mammary artery (ima) catheter, advanced a glidewire stiff exchange length into the right superficial femoral artery.We then exchanged our short 6-french sheath with a 6-french 45 cm cook sheath.We traversed the lesion.We predilated the sheath with a 5 mm balloon, and because the lesion was quite focal and responded pretty nicely to the balloon angioplasty, we proceeded to use the drug-coated balloon, admiral, 6x4.We did an 18 atmosphere dilatation for a total of 3 minutes.Follow-up angiographic results were excellent with, angiographically, no significant residual stenosis identified.There is no dissection.There is brisk flow.Sheathogram performed had demonstrated good access and therefore a proglide device was deployed with good hemostasis.
|