Over a seven-year period, during which time approximately 500 balloon-tipped catheters have been used in surgical procedures, six complications have been recognized. These were disruption of the posterior tibial artery, perforation of the popliteal artery, breaking off of the catheter tip in the profunda femoris artery, disruption of an intrahepatic bile duct, and two disruptions of saphenous vein in situ grafts while rendering valves incompetent. A review of the literature revealed a small but significant incidence of these and other complications. The importance of gentleness in the employment of the technique and intraoperative angiography in the management of these cases is stressed.