VASCULAR COMPLICATIONS OF INTRAAORTIC BALLOON PUMPING - UNSHEATHED VERSUS SHEATHED INSERTION

Incidence of vascular complications in intraaortic balloon counterpuls ation is still high despite major refinements in catheter design and t echniques. One hundred twenty-six patients in whom intraaortic balloon pumping was attempted were divided into two groups on the basis of in sertion technique. Group 1 included 77 patients in whom the convention al percutaneous insertion was used. In group 2 (n = 45 patients), a sh eathless insertion technique was used. The overall vascular complicati on rate was 19.6%, with the lower limb ischemia as the most common com plication. The vascular complication rate was 25.9% in group 1 and 8.8 % in group 2 (p < 0.01). Lower limb ischemia was noted in 17 patients in group 1 and 3 patients in group 2 (p < 0.01). These results suggest that sheathless insertion of the intraaortic balloon pump catheter ca n minimize vascular complications. This technique will be especially u seful in patients with peripheral vascular disease, in whom the likeli hood of vascular complications is high.