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The Intra-Aortic Balloon Pump
06:13

The Intra-Aortic Balloon Pump

Published on: February 5, 2021

In which patients should sheathless IABP be used? An analysis of vascular complications in 1211 cases

Hasan Basri Erdogan1, Deniz Goksedef, Vedat Erentug

  • 1Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, 34865 Kartal, Istanbul, Turkey.

Journal of Cardiac Surgery
|July 19, 2006
PubMed

Insights

The sheathless intraaortic balloon pump (IABP) insertion technique significantly reduces limb ischemia complications, especially in patients with peripheral arterial disease (PAD) and diabetes mellitus (DM). Preferring the sheathless method is crucial for patient safety.

Area of Science:

  • Cardiovascular Surgery
  • Medical Devices
  • Vascular Complications

Background:

  • Intraaortic balloon pump (IABP) insertion is a critical procedure for hemodynamic support.
  • Vascular complications, particularly limb ischemia, are significant concerns following IABP placement.
  • The choice of insertion technique, sheathed versus sheathless, may influence complication rates.

Purpose of the Study:

  • To compare the outcomes of sheathed and sheathless IABP insertion techniques.
  • To determine and compare the rates of vascular complications, specifically limb ischemia, between the two techniques.

Main Methods:

  • Retrospective analysis of 1211 patients undergoing IABP insertion over 19 years.
  • Evaluation of 305 sheathless (Group I) and 906 sheathed (Group II) IABP catheters.
  • Univariate analysis, logistic regression, and relative risk (RR) calculations to assess the impact of the introducer sheath.

Main Results:

  • Overall limb ischemia incidence was 10.9%.
  • The sheathless technique (Group I) showed a lower ischemic complication rate (5.2%) compared to the sheathed technique (Group II) (12.4%), despite a higher prevalence of peripheral arterial disease (PAD) in Group I.
  • Peripheral arterial disease (PAD) and diabetes mellitus (DM) were identified as significant risk factors for IABP-related ischemia.

Conclusions:

  • PAD, DM, and the sheathed insertion technique are major risk factors for limb ischemia during IABP use.
  • The use of an introducer sheath is the only modifiable risk factor among those identified.
  • The sheathless IABP insertion method is recommended for patients with PAD and DM to minimize the risk of limb ischemia.
Abstract

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