VASCULAR COMPLICATIONS FROM INTRAAORTIC BALLOONS - RISK ANALYSIS

Purpose: The purpose of this study was to assess the incidence of and predictors for vascular complications in patients who required periope rative intraaortic balloon pump (IABP) support. Methods: Data from 580 patients collected with a retrospective review were statistically ana lyzed with 25 perioperative parameters, and significant variables were evaluated with multivariate analysis. These data were also statistica lly compared with data from a 1983 study from our institution. Results : Vascular complications occurred in 72 patients (12.4%). The three ao rtic perforations were fatal. Ipsilateral leg ischemia occurred in 69 patients. Of these, ischemia was resolved in 82% of patients by IABP r emoval (21), thrombectomy (21), vascular repair (13), fasciotomy (2), or without intervention (2). Six patients died with the intraaortic ba lloon in place. Pour patients required amputation-for ischemia, but al l survived. Conclusions: Vascular complications were not predictive of operative death (p = 0.26). Risk analyses with 25 perioperative param eters revealed that history of peripheral vascular disease, female sex , history of smoking, and postoperative insertion were independent pre dictors of vascular complications. However, most risk for vascular com plications cannot be explained by these factors because of a low R(2) value. Compared with the results of our 1983 study, the incidence of I ABP-related complications has not changed, but the severity of complic ations has decreased significantly, and IABP-induced death has decreas ed significantly.