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Management of intraaortic balloon entrapment
Y Fukushima1, M Yoshioka, N Hirayama
1Department of Thoracic and Cardiovascular Surgery, Miyazaki Medical Association Hospital, Japan.
The Annals of Thoracic Surgery
|October 1, 1995
Summary
Intraaortic balloon entrapment can be resolved using urokinase clot-lysis or retrograde removal via the left axillary artery. These methods offer effective solutions for managing entrapped intraaortic balloons.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Device Complications
Background:
- Intraaortic balloon pumps (IABPs) are critical for hemodynamic support.
- Entrapment of IABPs within the vasculature presents a significant clinical challenge.
- Prompt and effective management strategies are essential to prevent patient harm.
Observation:
- Two distinct cases of intraaortic balloon entrapment were documented.
- Patient 1: Entrapment resolved by injecting urokinase into the balloon catheter's gas lumen.
- Patient 2: Successful retrograde removal of the entrapped balloon via the left axillary artery.
Findings:
- Intra-luminal urokinase administration facilitated balloon removal in one case.
- Axillary artery access provided a viable retrograde approach for extraction in another.
- A combined approach of initial clot-lysis followed by surgical removal is proposed.
Implications:
- Urokinase-mediated clot lysis is a potential non-surgical intervention for IABP entrapment.
- Retrograde removal through the axillary artery offers an alternative surgical strategy.
- Management guidelines for intraaortic balloon entrapment should consider these minimally invasive techniques.