VASCULAR COMPLICATIONS RELATED TO PERCUTANEOUS INSERTION OF INTRAAORTIC BALLOON PUMPS

The hemodynamic effects of intraaortic balloon pumps (IABPs) are well known. The use of IABPs is prone to many complications, including thos e classified as vascular. These complications are said to be more freq uent with percutaneous insertion techniques. These complications and t he algorithm for identifying patients who are most likely to suffer va scular complications were evaluated in a retrospective manner in a gro up of patients that received percutaneous IABPs. The study group consi sted of 449 patients. The mean age of these patients was 53.6 +/- 12.8 years (range, 18 to 80 years), and 24.7% were female. The early morta lity rate of these patients was 53.2%. The mortality for patients in w hom vascular complications developed was significantly higher than tha t in the patients who did not suffer any vascular complications (65.7% versus 50.8%; p = 0.018). Minor or major vascular complications devel oped in 17.4% (n = 78) of the patients. There was no statistical diffe rence in the frequency of complications between the patients who recei ved a sheathless IABP and those who received a sheathed IABP. Ischemic complications occurred in 16.6% of the patients who received a sheath less IABP and in 17.6% of the patients with sheathed IABPs (p > 0.05). Diabetic patients (relative risk, 2.5), female patients (relative ris k, 1.83), patients with peripheral vascular disease (relative risk, 3. 69), and patients undergoing coronary artery bypass operations (relati ve risk, 2.08) were at increased risk for suffering vascular complicat ions. These risk factors should be evaluated before insertion of an IA BP, and routes other than percutaneous femoral insertion are preferred if the patient is IABP dependent.