Intraaortic Balloon Pumping Through the Common Iliac Artery: Management of the Ambulatory Intraaortic Balloon Pump Patient

Garrett, Kim; Grady, Kathleen L.

doi:10.1111/j.0889-7204.2000.80383.x

Cited by 5 publications

(3 citation statements)

References 27 publications

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“…[7] Arterial sites used for IABP insertion include the femoral artery, subclavian artery, axillary artery, [8] ascending aorta through suprainguinal bypass grafts, and common iliac artery. [9] The axillary, ascending aorta, and common iliac artery approaches require insertion in the operating room. In contrast, a femoral artery IABP can be inserted percutaneously at the bedside, rendering this approach the most commonly utilized.…”

Section: Introductionmentioning

confidence: 99%

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Macapagal

Green²,

McClellan³

et al. 2017

JNEP

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The intraaortic balloon pump (IABP) is a treatment for end-stage heart failure patients not responsive to pharmacological therapy pre heart transplantation. An alternative approach-the percutaneously placed axillary-subclavian intraaortic balloon pump (PAxIABP) developed by cardiologists in our hospital enable patients to be mobilized while awaiting transplant versus the traditional bedrest in the femoral approach. Our objective is to determine if PAxIABP therapy enable pre-heart-transplant patients to safely mobilize. A retrospective study of pre-heart-transplant PAxIABP patients in the Coronary Intensive Care Unit (CICU) from 2007 to 2013 (n = 45; 35 men, 10 women) was conducted to determine mobility. Data are presented as mean (standard deviation) for continuous variables and number (percentage) for categorical variables. Patients were mobilized at 1.39 (± 1.41) days after PAxIABP insertion. The number of times mobilized per day was 1.79 (± 2). Transplant waiting time was 24.98 (± 25.03) days. Thirty-seven patients (82%) were transplanted. Two patients had a left ventricular assist device (LVAD) inserted and later transplanted. Six patients died before receiving a heart transplant, patients were 100% mobile. Complication rates: 4% bleeding; 7% ischemic complications; 2% IABP-related infection. Pre-heart-transplant patients receiving PAxIABP therapy can be safely mobilized. Nursing care protocols were developed to safely take care of this patient population. PAxIABP can be utilized for other procedures requiring long IABP therapy.

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Section: Introductionmentioning

confidence: 99%

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Macapagal

Green²,

McClellan³

et al. 2017

JNEP

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“…The intra‐aortic balloon pump (IABP) is the most commonly used temporary cardiac assist device (1–3) since its clinical introduction in 1962 by Moulopoulos et al (4,5)…”

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confidence: 99%

Variations in Aortic Pressure Affect the Mechanics of the Intra‐Aortic Balloon: An In Vitro Investigation

et al. 2010

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This study aims to investigate the mechanics of the intra-aortic balloon (IAB) under different aortic pressure (P(ao)) and inclination (0-75 degrees). Pressure and flow were measured in an artificial aorta during IAB pumping with a frequency of 1:3. Volume displaced toward the "coronary arteries" during inflation (V(prox)) and "intra-aortic" pressure reduction during deflation (P(r)) were derived. IAB duration of inflation and deflation was determined with a high-speed camera visualization. When the aorta was horizontal, P(ao) raised from 45 mm Hg to 115 mm Hg, V(prox) reduced by 18% (25.0 +/- 1.0 mL vs. 30.4 +/- 1.9 mL) and P(r) increased by 117% (106.4 +/- 0.3 mm Hg vs. 48.9 +/- 0.6 mm Hg). When the aorta was inclined, at low P(ao) of 45 mm Hg, V(prox) was reduced by 30% from 0 degrees to 45 degrees (19.8 +/- 2.3 mL vs. 28.3 +/- 1.7 mL) and P(r) was reduced by 66% (16.5 +/- 0.1 mm Hg vs. 48.9 +/- 0.6 mm Hg). However, at high P(ao) of 115 mm Hg, V(prox) remained unchanged with increasing angle (20.0 +/- 1.0 mL) and P(r) was reduced by 24% (80.6 +/- 0.8 mm Hg vs. 106.4 +/- 0.3 mm Hg). Increasing P(ao) increased duration of inflation. At low P(ao), increasing angle resulted in increasing duration of inflation, but at high P(ao), increasing angle had the opposite effect. Duration of deflation generally decreased with P(ao) and increased with increasing angle. The IAB pump is affected by both P(ao) and angle, indicating that non-normotensive patients or patients in the semi-recumbent position might not receive the full benefits of IAB counterpulsation.

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“…In these circumstances, there are several alternative methods to provide counterpulsation. Alternative routes for IABP catheter insertion include the subclavian, axillary, brachial, innominate, or iliac arteries [11–14, 18–23]. Availability of small IABP catheters can broaden the indication for these methods of insertion in an increasing number of patients encountered in daily cardiovascular practice [14].…”

Section: Discussionmentioning

confidence: 99%

Transaortic Intra-Aortic Balloon Pump Catheter Insertion through a Separate Saphenous Vein Graft in Patients with Severe Aortoiliac Disease

Toktaş

Yavuz

Eris

et al. 2014

The Scientific World Journal

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Background. Intra-aortic balloon pump (IABP) is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases. Methods. This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum. Results. The procedure was successfully performed in all the patients. The mean duration of IABP support was 54.0 ± 13.4 hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft. Conclusions. This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.

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Intraaortic Balloon Pumping Through the Common Iliac Artery: Management of the Ambulatory Intraaortic Balloon Pump Patient

Cited by 5 publications

References 27 publications

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Mobilizing pre-heart-transplant patients with a percutaneously placed axillary-subclavian intraaortic balloon pump: A retrospective study

Variations in Aortic Pressure Affect the Mechanics of the Intra‐Aortic Balloon: An In Vitro Investigation

Transaortic Intra-Aortic Balloon Pump Catheter Insertion through a Separate Saphenous Vein Graft in Patients with Severe Aortoiliac Disease

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