Usefulness of the low profile "True 8" intra-aortic balloon pumping catheter for preventing limb ischemia

The most important limitation in the use of an intra-aortic balloon pumping (IABP) is the risk of vascular complications. Recently, an IABP catheter w ith an 8.0 French shaft and low profile that may decrease the risk of vascu lar morbidity has been developed. We evaluated the in vitro balloon perform ance and the prevention of limb ischemia in clinical use. An 8.0 French IAB P catheter was compared with a standard 9.5 French catheter. Inflation time (IT), deflation time (DT), and changes in volume (V) generated by the ball oon were measured during the pumping cycle in an experimental model. The in flation velocity (VAT) and deflation velocity (V/IT) were calculated as par ameters of balloon performance. At 120 bpm the V/IT and V/DT were 0.34 ml/m sec and 0.28 ml/cosec with the 8.0 French, and 0.33 ml/msec and 0.24 ml/cos ec with the 9.5 French catheter. Twelve patients with coronary artery disea se, ranging in age from 41 to 87 years (mean, 66 years), who underwent IABP support, were divided into group 1 (8.0 French, n = 4) and group 2 (9.5 Fr ench, n = 8). Ankle-arm pressure index (API), lactate extraction ratio (LER ) in the limb with IABP insertion, and cardiac index (CI) were measured at 1, 12, and 24 hours postoperatively. There were no major vascular complicat ions and no counterpulsation related morbidity. There was no significant di fference between the two groups with regard to age, duration of IABP suppor t, and incidence of peripheral vascular disease and diabetes. The percentag e of women patients was significantly higher in group 1 (100% vs. 25%), whe reas body surface area was significantly smaller (1.45 +/- 0.14 vs. 1.68 +/ - 0.12 m(2)). The API in group 1 were slightly higher than those in group 2 throughout the observed period (not significant). The LER and CI showed no significant differences between the two groups. These results suggest that the 8.0 French IABP catheter with a low profile has an acceptable in vitro performance, and its clinical application may be effective in preventing l imb ischemia in a high-risk subset of patients such as women and smaller pa tients.