Issue |
J Extra Corpor Technol
Volume 15, Number 4, August 1983
|
|
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Page(s) | 109 - 112 | |
DOI | https://doi.org/10.1051/ject/1983154109 | |
Published online | 15 September 2023 |
Proceedings
A Modified Approach to Percutaneous Insertion of the Intra-Aortic Balloon
Saint Mary’s Hospital, Huntington, West Virginia
* Direct correspondence to John D. Harrah, M.D., 2828 First Avenue, Suite 302, Huntington, WV 25702
The perarterial intra-aortic balloon (PAIAB) insertion technique has been shown at our institution to significantly reduce ischemic complications common to intra-aortic balloon (lAB) use. This technique is a modification of the percutaneous insertion method and utilizes the same introducer system. The common femoral artery is exposed and the balloon inserted under direct visualization.
Forty-five consecutive patients underwent attempted (PAIAB) insertion. Successful passage on the first attempt was accomplished in 39 patients (87%) and in 42 patients (93%) when the contralateral femoral artery was employed. In three patients (7%), the balloon could not be passed via either femoral artery. In 36 patients, the balloons were inserted preoperatively for support of high risk left main or left main equivalent coronary artery disease or poor left ventricular function prior to anesthetic induction. Twenty-nine intra-aortic balloons were removed immediately post perfusion with no incidence of thrombus on the balloon or catheter. Thrombus was present on four of 13 intra-aortic balloons (31%) left in from one to seven days.
Balloon removal was accomplished in the operating room under direct vision which allows for assessment of the puncture site, thrombus removal, and arterial repair. Had the artery not been exposed, the four patients with thrombus present could have suffered limb ischemia.
© 1983 AMSECT
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