{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:41:51Z","timestamp":1792514511059,"version":"4.5.0"},"reference-count":23,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"abstract":"<jats:p>Introduction: Fetuses with congenital diaphragmatic hernia (CDH) treated with fetal endoscopic tracheal occlusion (FETO) require a second procedure to reverse tracheal occlusion before birth. In this study, we aimed to report the feasibility and perinatal outcomes of a modified technique for ultrasound-guided balloon bursting used as a primary attempt. Methods: From January 2012 to December 2025 a prospective cohort of isolated CDH cases treated with FETO was included in a management protocol for balloon removal by a percutaneous balloon bursting using a 22-gauge needle in a transversal view of the fetal trachea under simultaneous 2D and color Doppler ultrasound guidance (dual imaging) to avoid vessels. The feasibility of this technique, procedure-related characteristics, complications, and outcomes were evaluated. Results: During the study period, 88 (74 left-sided, and 14 right-sided) CDH were treated with FETO at a mean GA of 29.6 weeks. The balloon was removed at a mean GA of 33.8 weeks and as an emergency procedure in up to 40.7% of the cases. Percutaneous ultrasound-guided balloon puncture was feasible in 80% of the cases. Our technique was technically successful and allowed balloon rupture in up to 98.5% of the selected cases. No cases of fetal bleeding or intrauterine fetal demise after balloon removal were observed and, in all cases, a patent airway was confirmed after birth. Conclusion: Implementing a modified technique for percutaneous ultrasound-guided balloon bursting is safe and feasible and allows balloon rupture, avoiding the need for a second fetoscopic procedure for the reversal of FETO.<\/jats:p>","DOI":"10.1159\/fdt\/acuag009","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T11:39:09Z","timestamp":1789817949000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Endotracheal Balloon Bursting: Modified Technique for Percutaneous Ultrasound-Guided Balloon Puncture to Reverse Tracheal Occlusion in Congenital Diaphragmatic Hernia"],"prefix":"10.1159","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5999-866X","authenticated-orcid":false,"given":"Rogelio","family":"Cruz-Mart\u00ednez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saulo","family":"Molina-Giraldo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Savino","family":"Gil-Pugliese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Helue-Mena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Lavalle-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"Huaraz-Zuloaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"del Pozo-Orozco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00132584-200110000-00004"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.3.532"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/uog.3863"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5458"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1002\/uog.20216"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/uog.21993"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2027030"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.23121"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.11.1351"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.02.041"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13123572"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1002\/uog.27711"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6070"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1002\/pd.5988"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-3468(96)90338-3"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1002\/uog.4052"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1002\/uog.7577"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/s10397-018-1041-9"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1002\/uog.10142"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005491"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2023.101248"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1002\/pd.6803"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273878"}],"container-title":["Fetal Diagnosis and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/fdt\/acuag009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:01:28Z","timestamp":1792512088000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/fdt\/acuag009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,9]]},"references-count":23,"URL":"https:\/\/doi.org\/10.1159\/fdt\/acuag009","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33313812","asserted-by":"subject"}]},"ISSN":["1015-3837","1421-9964"],"issn-type":[{"value":"1015-3837","type":"print"},{"value":"1421-9964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,9]]}}}