Complications associated with percutaneous placement and use of intraaortic balloon counterpulsation

Eltchaninoff, Hélène; Dimas, Alexios P.; Whitlow, Patrick L.

doi:10.1016/0002-9149(93)90800-r

Cited by 75 publications

(35 citation statements)

References 27 publications

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“…Durch kleinere Katheter und die Einführung der perkutanen Implantation konnte die Komplikationsrate der IABP gesenkt werden [8,26]. Mit Komplikationen ist heute bei 10 bis…”

Section: Komplikationen Unter Iabp-therapieunclassified

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Aktueller Einsatz und Stellenwert der intraaortalen Ballongegenpulsation in der kardiologischen Routine

Mark¹,

Zahn²,

Dönges³

et al. 2000

Medizinische Klinik

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“…Durch kleinere Katheter und die Einführung der perkutanen Implantation konnte die Komplikationsrate der IABP gesenkt werden [8,26]. Mit Komplikationen ist heute bei 10 bis…”

Section: Komplikationen Unter Iabp-therapieunclassified

“…30% der Patienten zu rechnen [3,8,22,26]. Scholz et al [26] dokumentierten eine Abnahme der Komplikationsrate von 30% bei chirurgischer auf 18% bei perkutaner Implantation.…”

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Aktueller Einsatz und Stellenwert der intraaortalen Ballongegenpulsation in der kardiologischen Routine

Mark¹,

Zahn²,

Dönges³

et al. 2000

Medizinische Klinik

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“…griffen bei 0,1 bis 2% der Patienten [8,9,36,48,57,75,80,93]. Nach Eingriffen ª sehr dicklumige Schleusen (zum Beispiel IABP, passagerer Linksherzersatz, Va|vuloplastie) mit aggressiver A n t i k o a g u l a t i o n sind hohe Raten bis zu 3,5% schwerwiegender operationspflichtiger H~imatome oder B l u t u n g e n berichtet worden [30,93]. Ein retroperitoneales H~m a t o m wird in 0,15 bis 0,5% der beobachteten Patienten gesehen [56,961. Priidisponierende Faktoren: Ein Hfimatom tritt deutlich h~iufiger bei F r a u e n auf, zudem sind ein manifester arterieller Hochdruck, • und eine arterielle Verschlul3erkrankung ira Punktionsareal begª gen& Bei V e r w e n d u n g dicklumiger Schleusen und verlfingerter Schleusenliegezeit steigt die Blutungsrate an.…”

Section: Autor Jahrunclassified

Periphere arterielle Komplikationen nach Herzkatheteruntersuchung

Heintzen

Strauer

1998

Herz

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After diagnostic and interventional cardiac catheterization, local vascular complications at the arterial entry site must be expected. With respect to the method applied for catheterization and the puncture site, the type of complications may vary. With transfemoral approach a large variety of vascular complications have to be feared, mostly in the form of bleeding complications and hematomas, arterial dissections or occlusions, pseudoaneurysms and AV-fistulas. Each of these complications may have the potential for serious morbidity. When cardiac catheterization is performed via the arteries of the arm (either in the classical Sones technique by arterial cutdown to the brachial artery or by direct puncture of the brachial or radial artery) vascular occlusions will mostly occur as local vascular complications. These occlusions can often be managed conservatively or by a surgical procedure. The incidence of a vascular complication is mainly dependent on patient-related (sex, age, height, weight, arterial hypertension, diabetes, presence of peripheral vascular disease and compliance of the patient after withdrawal of the sheath) and procedure-related (arterial access site, diagnostic or interventional study, sheath size, periprocedural anticoagulation, duration of intra-arterial sheath placement, faulty puncture technique, operator skill) factors. In addition, the definition of a complication, the publication year of a certain study and the technique used for identification of complications seem to play a role for the reported incidence of peripheral vascular complications after cardiac catheterization. Currently, incidences of 0.1 to 2% for significant local vascular complications after diagnostic transfemoral catheterization are reported, after interventional transfemoral treatment 0.5 to 5% and after complex procedures using large sheath sizes with periprocedural anticoagulation (directional atherectomy, IABP, left-heart assist, valvuloplasty) up to 14%. Following transbrachial and transradial catheterization, local vascular complications at the entry site amount to 1 to 3% after diagnostic and 1 to 5% after interventional procedures. Local vascular complications may be diminished by a cautious and sensitive puncture technique with additional care in patients at higher risk for vascular complications (females, prediagnosed peripheral vascular disease, mandatory anticoagulation, necessity for large sheaths). By using smaller sized catheters and an adequate, defensive anticoagulation regimen, the rate of arterial access site complications may be reduced. Proper methods for achievement of hemostasis as well as a close and careful observation after sheath withdrawal are required.

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“…Complications of intra-aortic counterpulsa tion consist principally of limb ischemia, bleeding and infection. The use of smaller diameter (8.5-10.5 french) catheters has reduced the in-hospital complication rate to 13% in a recently reported series [57], We routinely insert an IABP in any hemodynamically compromised patient with acute myocardial infarction prior to attempting an interventional coronary procedure.…”

Section: Interventional Therapy Of Cardiogenic Shock and Mechanical Smentioning

confidence: 99%

Aggressive Interventional Treatment of Acute Myocardial Infarction

Feld

Kjellgren

Smalling³

1995

Cardiology

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Myocardial necrosis progresses with the duration of coronary occlusion in the early stages of acute myocardial infarction. Prompt recanalization of the infarct-related artery resulting in effective and sustained reperfusion of jeopardized myocardium is the goal of modern therapy. Clinical thrombolysis trials have demonstrated a significant survival advantage for treated patients, but only a modest recovery of global or regional systolic left ventricular function. Accelerated regimens of administering currently available thrombolytic agents are associated with early coronary patency rates approaching 85%, although effective coronary perfusion is restored in only slightly better than one half of patients treated. Primary angioplasty without antecedent thrombolytic therapy has resulted in high patency rates with superior coronary flow when performed in some experienced centers. Treatment of cardiogenic shock requires immediate mechanical or surgical intervention to reestablish coronary perfusion often following placement of a circulatory assistance device. Future trends toward very early initiation of thrombolytic therapy, improvements in adjunctive therapy and advances in the noninvasive detection of recanalization should permit selective use of aggressive interventional therapy for failed thrombolysis in a minority of patients with acute myocardial infarction.

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Complications associated with percutaneous placement and use of intraaortic balloon counterpulsation

Cited by 75 publications

References 27 publications

Aktueller Einsatz und Stellenwert der intraaortalen Ballongegenpulsation in der kardiologischen Routine

Aktueller Einsatz und Stellenwert der intraaortalen Ballongegenpulsation in der kardiologischen Routine

Periphere arterielle Komplikationen nach Herzkatheteruntersuchung

Aggressive Interventional Treatment of Acute Myocardial Infarction

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