Severe Intra-aortic Balloon Pump Complications: A Single-Center 12-Year Experience

Severi, Luca; Vaccaro, Paola; Covotta, Marco; Landoni, Giovanni; Lembo, Rosalba; Menichetti, Antonio

doi:10.1053/j.jvca.2012.01.037

Cited by 17 publications

(13 citation statements)

References 7 publications

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“…The value of some trials is to be questioned in the light of the unacceptably high rate of intra-aortic balloon pump-related complications [ 26 , 27 ]. The most recent trial [ 10 ] reported two patients in the intra-aortic balloon pump study group who did not receive the balloon due to technical difficulties and four patients suffering from vascular complications (12%).…”

Section: Discussionmentioning

confidence: 99%

Preoperative intra-aortic balloon pump to reduce mortality in coronary artery bypass graft: a meta-analysis of randomized controlled trials

et al. 2015

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IntroductionThe intra-aortic balloon pump is routinely used in cardiac surgery; however, its impact on outcome is still a matter of debate and several randomized trials have been published recently. We perform an updated meta-analysis of randomized controlled trials that investigated the use of preoperative intra-aortic balloon pump in adult patients undergoing coronary artery bypass grafting.MethodsPotentially eligible trials were identified by searching the Medline, Embase, Scopus, ISI Web of Knowledge and The Cochrane Library. Searches were not restricted by language or publication status and were updated in August 2014. Randomized controlled trials on preoperative intra-aortic balloon pump in patients undergoing coronary artery bypass grafting either with or without cardiopulmonary bypass were identified. The primary end point was mortality at the longest follow-up available and the secondary end point was 30-day mortality.ResultsThe eight included randomized clinical trials enrolled 625 patients (312 to the intra-aortic balloon pump group and 313 to control). The use of intra-aortic balloon pump was associated with a significant reduction in the risk of mortality (11 of 312 (3.5%) versus 33 of 313 (11%), risk ratio = 0.38 (0.20 to 0.73), P for effect = 0.004, P for heterogeneity = 0.7, I-square = 0%, with eight studies included). The benefit on mortality reduction was confirmed restricting the analysis to trials with low risk of bias, to those reporting 30-day follow-up and to patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass.ConclusionsPreoperative intra-aortic balloon pump reduces perioperative and 30-day mortality in high-risk patients undergoing elective coronary artery bypass grafting.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-014-0728-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Preoperative intra-aortic balloon pump to reduce mortality in coronary artery bypass graft: a meta-analysis of randomized controlled trials

et al. 2015

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“…Likewise, the incidence of ALI following open cardiac or thoracic surgery is 1.4-1.7% with resultant mortality rates as high as 45% (17). ALI is also a recognized complication of 0.9-21% of intra-aortic balloon pump (IABP) insertions, especially with patients who have risk factors like peripheral arterial disease and diabetes mellitus (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Acute Limb Ischemia Secondary to Iatrogenic Distal Embolization Using Catheter Directed Aspiration Thrombectomy

et al. 2020

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Objective: Acute limb ischemia (ALI) due to thromboembolism is a limb-and life-threatening condition regularly encountered by vascular surgeons. Iatrogenic distal embolization is occasionally seen as a complication of various endovascular procedures. We present a series of four patients who developed ALI due to arterial embolization during cardiovascular procedures that were successfully treated via catheter directed aspiration embolectomy. Methods: Retrospective review of demographics, risk factors, and procedural outcomes was completed for 4 patients who presented with ALI due to distal embolization following cardiovascular procedures. All patients were successfully treated with catheter directed aspiration embolectomy using the Penumbra Indigo System (Penumbra Inc., Alameda, California). All patients had high-quality angiography demonstrating successful embolectomy and end-procedure patency. Results: Three patients presented with Rutherford 2A and one with Rutherford 2B ALI secondary to intraoperative distal embolization. Three patients presented with ALI secondary to distal embolization during peripheral vascular interventions, and one following emergent intra-aortic balloon pump (IABP) placement for myocardial infarction. All emboli were located in the infra-inguinal vasculature. Median post-operative ABIs were 0.94 (n = 4). Median length of stay was 2 days. There were no mortalities and no need for adjunctive fasciotomy, amputation, or bypass for limb salvage. All patients improved clinically after intervention, and returned to their reported pre-hospitalization functional status. Conclusion: All procedures achieved technical success with catheter-directed aspiration thrombectomy with or without adjunctive lysis. Catheter-directed aspiration embolectomy with the Penumbra Indigo System for ALI following an iatrogenic embolic event is a safe, less-invasive treatment option. The use of this technology may reduce the need for traditional open thrombectomy or thrombolytic therapy to address ALI.

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“…Die Bewertung der Häufigkeit verschiedener Komplikationen ist aufgrund inhomogener Definitionen in den einzelnen Studien allerdings schwierig, das Risiko schwankte zwischen 1 und 13% [15,20] …”

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“…Diese Komplikationen treten mit einer Inzidenz von etwa 7% [15,19,20] auf und ziehen zumeist einen weiteren chirurgischen Eingriff sowie die Explantation der IA-BP nach sich. Neue Daten aus der IABP-SHOCK-II-Studie [17] lassen zudem die Sinnhaftigkeit der IABP bei akuten Infarktpatienten fraglich erscheinen.…”

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Einfluss von ECMO und IABP auf die Koronardurchblutung

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et al. 2014

Med Klin Intensivmed Notfmed

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Severe Intra-aortic Balloon Pump Complications: A Single-Center 12-Year Experience

Cited by 17 publications

References 7 publications

Preoperative intra-aortic balloon pump to reduce mortality in coronary artery bypass graft: a meta-analysis of randomized controlled trials

Preoperative intra-aortic balloon pump to reduce mortality in coronary artery bypass graft: a meta-analysis of randomized controlled trials

Successful Treatment of Acute Limb Ischemia Secondary to Iatrogenic Distal Embolization Using Catheter Directed Aspiration Thrombectomy

Einfluss von ECMO und IABP auf die Koronardurchblutung

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