Prospective Evaluation of Factors Associated With Intraaortic Balloon Rupture

Patel, Jeetesh V.; Kopistansky, Christine; Boston, Barbara; McBride, Ruth; Rzepela, A; Asla, de; Cohen, Mark W.

doi:10.1097/00002480-199601000-00010

Cited by 7 publications

(8 citation statements)

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“…Potential advantages of lubricious coatings include diminished friction during IAB insertion, improved tracking through tortuous vessels, decreased vascular trauma, and reduced balloon abrasion. Previous studies have suggested that IAB rupture is increased in smaller patients and is related to abrasion of the balloon by calcified plaques in the descending thoracic and abdominal aorta [12][13][14]. This observation was supported by a nonrandomized study demonstrating a reduction in balloon rupture from 8% to 2% using a shorter 34-cc IAB catheter [13].…”

Section: Discussionmentioning

confidence: 82%

“…Major complications reported in recent series include vascular ischemia (4%-17%), need for vascular surgical repair (4%-8%), IAB rupture (2%-8%), and major bleeding (Ն4%) [3][4][5]7,8,[10][11][12][13][14]. While previous studies have demonstrated that female gender, diabetes mellitus, and peripheral vascular disease are predictors of vascular complications [2][3][4][5][6]8,10], to date no modification of an IAB catheter or insertion technique has consistently reduced the complication rate associated with IAB counterpulsation [10,15].…”

Section: Introductionmentioning

confidence: 99%

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Reduction in ischemic vascular complications with a hydrophilic-coated intra-aortic balloon catheter

Winters

Smith

Cohen

et al. 1999

Cathet. Cardiovasc. Intervent.

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Hydrophilic coatings improve the handling characteristics of angioplasty equipment, but until recently this technology has not been available for intra‐aortic balloon (IAB) catheters. To determine whether a new hydrophilic coating is associated with a reduction in IAB‐related complications, we prospectively evaluated 188 patients undergoing insertion of this new IAB catheter. Complications related to IAB insertion were recorded and compared to data from 682 patients previously treated with an uncoated IAB catheter of the same shaft diameter and balloon size. By multivariate analysis the hydrophilic‐coated IAB catheter was associated with a 72% reduction in ischemic vascular complications (relative risk 0.28, 95% CI 0.08–0.96, P = 0.04). There were also trends toward reductions in IAB rupture and the need for vascular surgical repair for bleeding or ischemia. While further investigation is warranted, hydrophilic coatings that reduce the coefficient of friction during IAB catheter insertion may also reduce subsequent ischemic vascular complications. Cathet. Cardiovasc. Intervent. 46:357–362, 1999. © 1999 Wiley‐Liss, Inc.

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Section: Discussionmentioning

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Reduction in ischemic vascular complications with a hydrophilic-coated intra-aortic balloon catheter

Winters

Smith

Cohen

et al. 1999

Cathet. Cardiovasc. Intervent.

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“…11 Fatal complication of balloon rupture may occur in case of large intraaortic balloon in the patient with small or severely atherosclerotic aorta, causing mechanical abrasion. 12,13 Size and shape of the aorta may vary among individuals and even in individuals as they get older. Recent progress in the imaging technology brought about many anatomical studies, especially for the aortic aneurysm that had fatal risk of rupture proportional to its size.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, there was no concern about the diameter of the balloon because the commercial guideline contained only a height criterion. Considering the diameter, mismatch is the most important risk factor of balloon rupture, 12 and further investigation seems to be helpful.…”

Section: Discussionmentioning

confidence: 99%

Should We Consider the Ethnic Difference in Selecting Size of Intraaortic Balloon by Commercial Guideline?

et al. 2009

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To evaluate the appropriateness of commercial guideline in selecting the size of balloon for intraaortic counterpulsation in Asian patients, we analyzed the relationship between aortic dimensions measured from computed tomography and body indexes. There were 125 patients who underwent the computed tomography. They were divided into three height groups [<152 cm (I), 152-162 cm (II), and 163-183 cm (III)]. Aortic length and diameter were obtained from the origin of left subclavian artery to the orifice of renal artery. We compared those measurements with the balloon size according to the commercial guideline. Aortic lengths were measured as 250 +/- 15 (233-289), 262 +/-16 (227-298), and 285 +/- 19 (239-334) mm in each group, respectively. As the guideline, if we insert the balloon of 25 ml/191 mm, 34 ml/236 mm, and 40 ml/280 mm, there will be 29 of 66 patients (44%) in group III, who have shorter aortic length, with increased risk of obstructing renal artery. In addition, the younger the patient the higher is the risk (p = 0.038). We should pay attention to proper positioning of intraaortic balloon in younger Asian patients with 163-183 cm height, in applying the commercial guideline to prevent renal arterial obstruction.

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“…None of the 112 used IABs had failed in initial use. Balloon rupture has been well acknowledged as a complication of counterpulsation but is fortunately very rare (21,22). The present study has investigated the impact of the clinical use of these devices which had been used satisfactorily in humans for varying periods of time.…”

Section: Discussionmentioning

confidence: 99%

Are Intraaortic Balloons Suitable for Reuse? A Survey Study of 112 Used Intraaortic Balloons

Yang¹,

Deng²,

Zhang³

et al. 1997

Artificial Organs

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To assess the safety of reusing single-use intraaortic balloon devices (IABs), 112 used devices were investigated in terms of physical integrity, gas leakage inspection, mechanical performance, surface chemistry and morphology. and physical stability. These IABs were all used clinically only once, and the duration of the IABs in vivo ranged from 6 to 312 h. Macroscopic examination of the balloons and the outer catheters revealed n o obvious change in either shape or color. No discernible abrasions or cracks were observed on the balloons. However, 61 Yo of the balloons were creased, and 40% of the central lumens and 21% of the sheaths showed visible bending flaws.

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Prospective Evaluation of Factors Associated With Intraaortic Balloon Rupture

Cited by 7 publications

References 0 publications

Reduction in ischemic vascular complications with a hydrophilic-coated intra-aortic balloon catheter

Reduction in ischemic vascular complications with a hydrophilic-coated intra-aortic balloon catheter

Should We Consider the Ethnic Difference in Selecting Size of Intraaortic Balloon by Commercial Guideline?

Are Intraaortic Balloons Suitable for Reuse? A Survey Study of 112 Used Intraaortic Balloons

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