Entrapping of the clotted intra-aortic ballon in the descending aorta

Abstract

Percutaneous insertion of a catheter for intra-aortic balloon pumping (IABP) was introduced in 1979 by Bregman and Casarella and has become a popular technique. Rupture of the balloon, allowing clot to form inside it, is rare. When the clot is large, it may cause entrapping of the balloon. This is a potentially dangerous complication of IABP. We are aware of only one case report of this complication, by Aru and co-workers. The entrapping of the balloon in their report occurred at the site of insertion in the femoral artery. We report here a case in which the entrapping occurred in the descending aorta, and its removal required extensive exposure of the aortic bifurcation.

Intra-Aortic Balloon Pump Entrapment in a Nonatherosclerotic Common Iliac Artery

“…We noticed evidence of balloon rupture by leakage of blood from the balloon which formed a hardened clot that was not easy to detect clinically. Shafei et al 9 and Lambert 10 reported that balloon rupture and leakage occurred in up to 15.4% of cases. 9 , 10 Tears can be attributed to design and manufacturing issues, insertion technique, and the atherosclerotic nature of the arteries into which an IABP is introduced.…”

Retained intra‐aortic balloon pump catheter causing acute ischaemic limb: Report of two cases

“…The most common complication is limb ischaemia, mainly as a result of thromboembolism. Other major complications are bleeding, arterial injury, infection and paraplegia 5,6 . Entrapment of IABP is extremely rare.…”

“…In most reported cases, surgical exploration and arteriotomy have been used for the removal of an entrapped IABP catheter 5–7,10 . The iliac arteries can be exposed either intraperitoneally or extraperitoneally.…”

“…These include leg ischaemia, vascular injury, infection, haematoma and paraplegia. However, retained IABP requiring surgical removal is extremely rare 5,6 . Two cases of retained IABP that resulted in acute ischaemic limb, which recently occurred at the Queen Elizabeth Hospital, are described here.…”

Thrombogenicity of Deflated Intraaortic Balloon: Impact of Heparin Coating

“…Occasionally, when a rupture is due to a leak with progressive loss in deflation‐inflation efficiency and a great delay in removal, blood can enter the balloon causing device entrapment ( 21). The tested device of this study, which is coated outside, is not intended to prevent these rare situations because inside coating is unlikely to prevent the clotting of a substantial amount of blood trapped in the balloon.…”