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The Intra-Aortic Balloon Pump
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Transradial-Guided Percutaneous Transaxillary Intra-aortic Balloon Pump Insertion

Samual Hayman1, Shahar Lavi1, Ryan Davey1

  • 1Division of Cardiology, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada.

The Canadian Journal of Cardiology
|December 26, 2017
PubMed

Insights

Axillary access for intra-aortic balloon pumps enables advanced heart failure patients to ambulate. A novel radial access technique improves safety for this critical procedure in anticoagulated patients.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Advanced heart failure necessitates mechanical circulatory support.
  • Intra-aortic balloon pumps (IABP) improve hemodynamics but require vascular access.
  • Axillary artery access offers advantages for ambulation in patients awaiting advanced therapies.

Observation:

  • Standard axillary access can be challenging, particularly in anticoagulated patients.
  • A combined radial and axillary approach was utilized.
  • A 4F pigtail catheter was introduced via radial access for angiography.

Findings:

  • The radial approach facilitated precise axillary artery visualization.
  • This provided a clear target for safe micropuncture needle entry.
  • The technique was successfully applied in a fully anticoagulated patient.

Implications:

  • This modified technique enhances the safety and feasibility of axillary IABP insertion.
  • It potentially expands IABP use in complex, anticoagulated heart failure populations.
  • Improved patient mobility during IABP support can be achieved, aiding recovery and bridging to transplantation.

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