Management of intra-aortic balloon pump rupture and entrapment: a case report and review of the literature

Introduction: Intra-aortic balloon pump (IABP) rupture with subsequent entrapment is a rare but serious complication. This report aims to present a case of IABP balloon rupture and entrapment, along with a systematic review of management strategies to guide clinical practice. Presentation of case: An 84-year-old female with acute ST-segment elevation myocardial infarction and cardiogenic shock underwent IABP implantation. Balloon rupture occurred 24 days later, accompanied by entrapment. Successful removal was achieved via laparotomy and right common iliac artery endarterectomy. The patient recovered without symptoms at 1-year follow-up. Discussion: IABP balloon rupture is uncommon (≈0.5%), often resulting from mechanical abrasion against atherosclerotic plaques. Early recognition and intervention are critical to prevent thrombosis and entrapment. Management options include thrombolysis, percutaneous extraction, or surgical removal depending on timing and clinical context. Conclusion: Prompt identification of balloon rupture and appropriate intervention are essential to avoid severe complications. A structured management algorithm is recommended to optimize outcomes.