Complications associated with percutaneous placement of intra-aortic balloon counterpulsation: can unsheathed insertion reduce limb ischaemia?

Complications related to percutaneous placement of intra-aortic balloon pum p counterpulsation are still high despite major refinements in catheter des ign and techniques. One hundred and forty-eight patients in whom intra-aort ic balloon pumping was inserted were classified into two groups on the basi s of the insertion technique. Group I included 103 patients in whom the con ventional percutaneous insertion was used. A sheathless insertion technique was used in group II (n = 45), The overall complication rate was 16.6% (25 of 150), in which lower limb ischaemia was the most common complication. T he limb ischaemia was noted in 12 patients (11.5%) in group I and 4 patient s (8.9%) in group II (statistically not significant). Peripheral vascular d isease, diabetes mellitus and female gender were found to be significant pr edictors of limb ischaemia (p = 0.01, p = 0.02 and p = 0.03, respectively). In conclusion, sheathless insertion of intra-aortic balloon pump catheters does not reduce the incidence of limb ischaemia.