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Vascular complications associated with intraaortic balloon pump supported percutaneous coronary intervention (PCI)

Tim Kinnaird1,2, Richard Anderson1, Sean Gallagher1

  • 1Department of Cardiology, University Hospital of Wales, Cardiff, UK.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|February 9, 2021
PubMed

Insights

Vascular complications (VCs) during intraaortic balloon pump (IABP)-supported PCI increase in-hospital morbidity but do not affect survival. Radial access reduces VC risk, while procedural complications and female sex increase it.

Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Intraaortic balloon pump (IABP) use during percutaneous coronary intervention (PCI) is associated with specific complications.
  • The clinical impact of vascular complications (VCs) during IABP-supported PCI on patient outcomes remains incompletely understood.

Purpose of the Study:

  • To identify predictors of VCs in patients undergoing IABP-supported PCI.
  • To evaluate the association between VCs and clinical outcomes, including morbidity and mortality.

Main Methods:

  • Analysis of data from the BCIS National PCI Database (2007-2014).
  • Multivariate logistic regression and propensity scoring to identify VC predictors and assess outcome associations.
  • Inclusion of 9,970 IABP-supported PCI procedures.

Main Results:

  • Vascular complications occurred in 2.3% of IABP-supported PCIs, with rates decreasing with increased radial access use.
  • Predictors of VCs included procedural complications, female sex, PCI for stable angina, and glycoprotein inhibitor use.
  • VCs were associated with increased transfusion, acute kidney injury, and periprocedural myocardial infarction, but not adjusted mortality at discharge or 12 months.
  • A trend towards higher mortality was observed in patients with VCs undergoing PCI for stable angina.

Conclusions:

  • Vascular complications during IABP-supported PCI are associated with increased in-hospital morbidity.
  • Despite increased morbidity, IABP-related VCs did not significantly impact in-hospital or 1-year survival.
  • Radial access is associated with a reduced likelihood of VCs, highlighting its importance in mitigating procedural risks.
Abstract

Keywords:
bleedingcomplicationsintraaortic balloon pumppatient outcomesvascular complications

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