Complications of Percutaneous Intra-aortic Balloon Pump Use in Patients With Peripheral Vascular Disease

Abstract

Percutaneous intra-aortic balloon pump use may carry an increased risk for patients with peripheral vascular disease. To determine the incidence and types of associated complications, the medical records of 144 patients who underwent a total of 153 percutaneous intra-aortic balloon pump insertions were reviewed. Patients were divided into two groups. Group 1 was composed of 20 patients with a history of peripheral vascular disease. Group 2 was composed of 124 patients without such history; they underwent a total of 133 insertions. Nineteen major complications (12%) occurred, 12 in group 1 (60% of 20 insertions) and seven in group 2 (5% of 133 insertions). Major complications were further classified by their nature: embolic, occlusive, and technical. All three types of complications occurred more frequently in group 1. Embolic complications occurred more frequently in patients with aneurysms and proved the most lethal, with two of six deaths in group 1 resulting from this complication.

Intraaortic balloon pump insertion after percutaneous revascularization in patients with severe peripheral vascular disease

“…The complication rate in the current study appears to be consistent with that reported in prior studies of IABP use. Death has been reported in 30% of patients with PVD and in 15% of patients without PVD [17]. This is similar to the rate observed in the current study (33% and 22%, respectively).…”

“…Prior studies have documented an increased risk of limb ischemia in patients with PVD undergoing IABP placement [12][13][14][15][16][17][18]. Percutaneous transluminal angioplasty of iliac stenoses to facilitate IABP insertion has been reported in four patients [21].…”

“…Limb ischemia, the most common complication following IABP placement, occurs in up to 20% of patients, and is more prevalent in patients with PVD [13][14][15][16][17][18]. Many who might clinically benefit from IABP support have concomitant PVD and have not been able to benefit from this therapy.…”

Intra aortic balloon pump: literature review of risk factors related to complications of the intraaortic balloon pump

“…In a retrospective study assigned to Kvilekval et al [19], 144 cases of patients that were treated with IABP were re-examined. Patients were divided into two groups.…”

Noncardiac vascular complications of coronary bypass procedures: A review

“…Loss of Doppler signals is common after IABP insertion, and, in most cases, requires only conservative management [25,26]. Ischemia can occur secondary to luminal obstruction with thrombosis, thromboembolism, vessel spasm, occlusion of collaterals, and direct injury to the artery [23,27]. Peripheral vascular disease, aneurysmal disease, cardiogenic shock, smoking, female gender, obesity, hypertension, diabetes mellitus, and method of catheter insertion have all been identified as risk factors for vascular complications after IABP insertion (Table 2) [21,23,28].…”