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Updated: Oct 2, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Intra-aortic balloon pump placement following aorto-iliac angioplasty and stent placement
William R Colyer1, Mark W Burket, Gary M Ansel
1Medical College of Ohio, 3000 Arlington Avenue, Toledo, OH 43614, USA.
Insights
Angioplasty and stenting safely enable intra-aortic balloon pump (IABP) placement in patients with severe aorto-iliac disease. This revascularization strategy improves vessel diameter and is effective for facilitating IABP use.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Intra-aortic balloon pump (IABP) use is limited in ~20% of patients due to aorto-iliac atherosclerotic disease.
- Aorto-iliac stenoses often preclude IABP insertion, necessitating alternative strategies.
Purpose of the Study:
- To evaluate the safety and efficacy of angioplasty or stent placement to facilitate IABP insertion in patients with peripheral vascular disease.
- To assess outcomes including limb ischemia and mortality associated with this combined approach.
Main Methods:
- Retrospective analysis of 37 IABP placements in 35 patients with aorto-iliac disease.
- Performed 45 revascularization procedures (angioplasty/stenting) prior to or during IABP insertion.
- Monitored for complications such as limb ischemia and bleeding, and assessed mortality rates.
Main Results:
- Revascularization significantly increased minimal lumen diameter (2.78 to 6.75 mm, P < 0.0001).
- Limb ischemia occurred in 5% of IABP insertions, managed conservatively with revascularization.
- Overall mortality was 32%, with higher rates in patients with renal insufficiency and acute myocardial infarction.
Conclusions:
- Angioplasty or stenting is a safe and effective strategy to enable IABP placement in patients with peripheral vascular disease.
- This approach successfully facilitates IABP use, despite associated risks in high-risk patient groups.
Abstract:
Approximately 20% of patients are unable to receive an intra-aortic balloon pump (IABP) due to aorto-iliac atherosclerotic disease. Aorto-iliac stenoses can be managed with angioplasty or stent placement; however, there are limited data about this strategy to facilitate IABP placement. Thirty-seven IABPs were placed in 35 patients. A total of 45 revascularization procedures were performed. With revascularization, the minimal lumen diameter increased from 2.78 +/- 1.46 to 6.75 +/- 2.36 mm (P < 0.0001). Limb ischemia occurred following 2/37 (5%) IABP insertions. Limb ischemia was managed with IABP removal and angioplasty. The mortality rate was 32%. Mortality was more common with chronic renal insufficiency (8/11, 73%; P = 0.0014), dialysis-dependent renal failure (3/3, 100%; P = 0.028), and presentation with acute myocardial infarction (8/15 patients, 53%; P = 0.036). Although no patients required vascular surgery for limb ischemia, one patient required surgery for bleeding. Angioplasty or stenting to facilitate IABP placement in patients with peripheral vascular disease is safe and effective.