Related Experiment Videos
A prospective randomized study comparing surgical and percutaneous removal of intraaortic balloon pump
M J Rohrer1, C A Sullivan, D J McLaughlin
1Division of Vascular Surgery, University of Massachusetts Medical Center, Worcester 01655.
Insights
Percutaneous removal of intraaortic balloons is as safe as surgical removal, with fewer complications. This method is more cost-effective and recommended for most patients.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Intraaortic balloon pumps (IABPs) are crucial for hemodynamic support.
- Methods for IABP removal include surgical and percutaneous techniques.
- Complication rates and cost-effectiveness of removal methods require comparison.
Purpose of the Study:
- To compare the complication prevalence between surgical and percutaneous removal of intraaortic balloons.
- To evaluate the safety and efficacy of percutaneous IABP removal.
Main Methods:
- Prospective randomized study of 50 patients undergoing percutaneous IABP placement.
- Patients randomized to either surgical (n=25) or percutaneous (n=25) removal.
- Exclusion criteria included surgical placement, coagulopathy, or leg ischemia.
Main Results:
- Two complications in the surgical group: wound infection and lymph fistula.
- One complication in the percutaneous group: femoral artery false aneurysm.
- No significant difference in removal time (p=0.74).
- Percutaneous removal is more cost-effective due to reduced personnel and equipment needs.
Conclusions:
- Percutaneous removal of intraaortic balloons is safe and effective for the majority of patients.
- Surgical removal is recommended for patients with bleeding diatheses, specific complications, or surgical insertion.
- Percutaneous removal offers a cost-effective alternative to surgical removal.
Abstract:
This prospective randomized study of 50 patients compares the prevalence of complications between surgical and percutaneous methods of removal of intraaortic balloons. All patients who had percutaneous placement of a 9.5F intraaortic balloon during a 6-month period were eligible for the study. Patients were excluded if the intraaortic balloon was placed surgically, if a coagulopathy was present, or if acute leg ischemia developed at any time after insertion. After informed consent, 25 patients were randomized to each method of removal. Two complications occurred in the surgical group, including a wound infection and a lymph fistula. In one patient in the percutaneous group, a false aneurysm of the femoral artery developed. There was no significant difference between the mean of 59 minutes for percutaneous removal and 47 minutes for operative removal of the balloon (p = 0.74). The percutaneous method is therefore more cost-effective, because it does not require the use of operating room personnel or equipment necessary for surgical removal. The results of this study indicate that the majority of percutaneously placed intraaortic balloons may be safely removed percutaneously. Surgical removal of 9.5F intraaortic balloons is recommended for patients with bleeding diatheses, hemorrhagic or ischemic complications, or for those in whom the intraaortic balloon was inserted with a surgical procedure.