Reduced vascular complication after IABP insertion using smaller sized catheter and sheathless technique

Menon, Praveen; Totaro, Pasquale; Youhana, Aprim; Argano, Vincenzo

doi:10.1016/s1010-7940(02)00345-7

Cited by 12 publications

(7 citation statements)

References 5 publications

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“…There are patients, notably those who present with or develop cardiogenic shock refractory to volume expansion, who likely benefit from IABP use, and studies suggest that IABPs have been persistently underused in this situation 1, 25 . Instead, the results of this analysis highlight the variations in IABP use that exist across hospitals, and should prompt interventional cardiologists and PCI capable hospitals to critically examine their practice patterns and, perhaps, consider adopting a more selective approach to IABP use in high risk PCI.…”

Section: Discussionmentioning

confidence: 99%

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Curtis

Rathore

Wang

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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Background IABPs are frequently used to provide hemodynamic support during high risk percutaneous coronary intervention (PCI), but clinical evidence to support their use is mixed. We examined hospital variation in IABP use among high risk PCI patients, and determined the association of IABP use on mortality in this population. Methods and Results We analyzed data submitted to the CathPCI Registry® between January 2005 and December 2007. High risk PCI was defined as having at least one of the following features: unprotected left main artery as the target vessel, cardiogenic shock, severely depressed left ventricular function, or ST segment elevation myocardial infarction. Hospitals were categorized into quartiles by their proportional use of IABP. We examined differences in in-hospital mortality across hospital quartiles using a hierarchical logistic regression model to adjust for differences in patient and hospital characteristics across hospital quartiles of IABP use. IABPs were used in 18,990 (10.5%) of 181,599 high risk PCIs. Proportional use of IABP varied significantly across hospital quartiles: Q1: 0.0%–6.5%; Q2: 6.6% to 9.2%; Q3: 9.3% to 14.1%; and Q4: 14.2% to 40.0%. In multivariable analysis, after adjustment for differences in patient and hospital characteristics, in-hospital mortality was comparable across quartiles of hospital IABP usage (Q1: Ref; Q2: Odds Ratio (OR) 1.11, 95% CI 0.99–1.24; Q3: OR 1.03, 95% CI 0.92–1.15; Q4: OR 1.06, 95% CI 0.94–1.18). Conclusion IABP use varied significantly across hospitals for high risk PCI. However, this variation in IABP use was not associated with differences in in-hospital mortality.

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Section: Discussionmentioning

confidence: 99%

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Curtis

Rathore

Wang

et al. 2012

Circ: Cardiovascular Quality and Outcomes

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“…It also decreases left ventricular muscular tension by decreasing left ventricular afterload. Several clinical studies have reported better outcomes and lower complication rates in patients undergoing preoperative IABP compared with intraoperative or postoperative placement, due to critical hemodynamic decompensation (18)(19)(20). Hospital mortality was significantly lower in patients treated preoperatively with IABP compared with patients treated postoperatively (8.8 vs. 28.2%, P < 0.0001) (21).…”

Section: Discussionmentioning

confidence: 94%

Timing of Intra‐Aortic Balloon Pump Placement Before Off‐Pump Coronary Artery Bypass Grafting and Clinical Outcomes

Liu

Feng

et al. 2017

Artificial Organs

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We aimed to evaluate the timing of preoperative intra-aortic balloon pump (IABP) placement and outcomes in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Patients with prophylactic IABP placement before OPCAB presenting between January 1, 2010 and December 31, 2013 were included. Patients were categorized into two groups based on the timing of preoperative IABP placement: less than 2 h (Group A, n = 223) and more than 2 h (Group B, n = 94). According to the European System for Cardiac Operative Risk Evaluation (EuroSCORE), patients were divided into two subgroups: middle-low EuroSCORE (<6, Groups A1 and B1) and high EuroSCORE (≥6, Groups A2 and B2). Clinical data were compared between groups. Groups contained the following numbers of patients: Group A1, 163; Group A2, 60; Group B1, 60; and Group B2, 34. There was a significant difference in length of ICU and hospital stay between Group A and Group B, respectively (40.5 [22, 64] vs. 26.25 [18, 46.5] hours, P = 0.006; 16 [11, 22] vs. 11 [8, 14] days, P = 0.000). Duration of IABP support, ICU length of stay, hospital length of stay, and cost of hospitalization were significantly higher in Group A1 than in Group B1, respectively (73.69 ± 44.12 vs. 64.03 ± 40.93 h, P = 0.013; 36 [20, 56.5] vs. 25.5 [17, 43.75] hours, P = 0.035; 15(11,21) vs. 9(7.25, 12) days, P = 0.000; 109.53(101.20, 131.1) vs. 102.7(95.94, 115.32) thousands CNY, P = 0.009). The length of hospital stay was also significantly higher in Group A2 than in Group B2 (18(13, 26) vs. 13(11, 15) hours, P = 0.000). Preoperative placement of IABP greater than 2 h prior to OPCAB is of benefit, especially in those with high EuroSCORE. The optimal time for prophylactic IABP placement requires further study.

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“…Since that time, together with the demonstration of the reduced incidence of IABP-related complications with smaller sized catheter and sheathless technique [11], reports on liberal preoperative IABP support in patients considered at higher risk for acute myocardial infarction have appeared in the literature [10,11]. Accordingly, 53 patients in each group (35.3% of Group A, 29.4% of Group B) -referred for unstable ongoing angina despite maximal i.v.…”

Section: Flowmetric Analysis and Graft Flow Reserve (Gfr)mentioning

confidence: 99%

Radial artery graft flowmetry is better than saphenous vein on postero-lateral wall

Santarpino

Cristodoro

Scalas

et al. 2010

International Journal of Cardiology

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Reduced vascular complication after IABP insertion using smaller sized catheter and sheathless technique

Cited by 12 publications

References 5 publications

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Use and Effectiveness of Intra-Aortic Balloon Pumps Among Patients Undergoing High Risk Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry

Timing of Intra‐Aortic Balloon Pump Placement Before Off‐Pump Coronary Artery Bypass Grafting and Clinical Outcomes

Radial artery graft flowmetry is better than saphenous vein on postero-lateral wall

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