Utility of a Steerable Microcatheter in Balloon-assisted Coil Embolization for Inferior Epigastric Artery Injury Following Catheter Ablation: A Report of Two Cases

Inferior epigastric artery injury during femoral vein puncture is rare but typically occurs near its origin, requiring a careful and technically demanding approach. We report two cases of proximal right inferior epigastric artery injury following femoral vein puncture during catheter ablation. To minimize further damage, a steerable microcatheter was used to approach the distal inferior epigastric artery by adjusting its tip direction, and coil embolization was initiated distally. For proximal embolization, a balloon catheter was placed in the right external iliac artery for balloon-assisted, controlled coil packing at the origin. Complete hemostasis was achieved in both cases without complications. Balloon-assisted coil embolization using a steerable microcatheter appears to be an effective technique for managing proximal inferior epigastric artery injuries associated with femoral vein puncture.