Rescue strategy for management of an undeflating dual lumen balloon micro-catheter

Abstract

Background

Intracranial balloon microcatheters are vital in neurointerventions, yet balloon non-deflation has not been previously reported in the cerebral vasculature.

Method

We describe a 32-year-old woman undergoing embolization for a parieto-occipital arteriovenous malformation who developed failure of deflation of a dual-lumen balloon microcatheter placed in the posterior cerebral artery, despite standard manoeuvres.

Result

Controlled catheter transection distal to the hub, followed by gradual capillary action assisted drainage of diluted contrast, enabled safe balloon collapse and retrieval.

Conclusion

This case highlights a rare but critical complication and presents a practical bailout technique when conventional deflation methods fail, ensuring atraumatic intracranial balloon retrieval.