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Updated: Feb 24, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Vascular complications following intra-aortic balloon pump implantation: an updated review
Monique M de Jong1, Roberto Lorusso1, Fatima Al Awami1
11 Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht-CARIM, Maastricht, The Netherlands.
Insights
Intra-aortic balloon pump (IABP) use is controversial due to potential vascular complications like limb ischemia and bleeding. While incidence is generally low, risk factors and sheathless insertion methods warrant further study.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Intra-aortic balloon pump (IABP) use for cardiac support is debated due to inconsistent mortality benefits.
- Increased vascular complications may contribute to the lack of demonstrated benefit with IABP use.
Purpose of the Study:
- To review current literature on vascular complications associated with intra-aortic balloon pump (IABP) use.
- To assess the incidence and types of vascular complications during clinical IABP application.
Main Methods:
- A comprehensive literature search was conducted for adult human studies.
- The search focused on studies published between 1990 and 2016 reporting IABP complications.
Main Results:
- Twenty reports met the study criteria, identifying limb ischemia, bleeding, and mesenteric ischemia as common complications.
- The overall incidence of vascular complications varied widely (0.94%–31.1%).
- Risk factors identified include diabetes, peripheral vascular disease, hypertension, and smoking; sheathless insertion may reduce risks.
Conclusions:
- Intra-aortic balloon pump (IABP) is associated with major vascular complications, though generally at a low incidence.
- Further research is needed to fully elucidate the risk-benefit profile of IABP.
- Identifying risk factors and optimizing insertion techniques are crucial for patient safety.
Background:
The use of the intra-aortic balloon pump (IABP) as a support device remains controversial due to the fact that a number of studies have shown no benefit in end mortality whilst using this device. One of the reasons for this could be the increase in vascular complications when using the pump. Therefore, the aim of the present review was to assess the current literature available with regards to IABP vascular complications during the clinical situation.
Methods:
A literature search was performed, searching for IABP complications in adult human studies between 1990 and 2016.
Results:
A total of 20 reports were identified as fitting the criteria of this study. The majority of vascular complications were limb ischemia, bleeding or mesenteric ischemia. The overall incidence of vascular complications ranged from 0.94% to 31.1%. Diabetes, peripheral vascular disease and hypertension, as well as smoking were all identified as risk factors for complications following IABP. Furthermore, studies supported the use of sheathless balloon insertion to reduce the risk of complications.
Conclusion:
Major vascular complications, including limb and mesenteric ischemia as well as bleeding and hemorrhage, have been associated with IABP. However, the incidence of these complications was generally low. Further studies are still required to truly understand the risk/benefit associated with the use of IABP.
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