Factors influencing vascular complications of Intra-aortic balloon pump

AbstractBackground: We evaluated the vascular complications of Intra-aortic balloon pump and risk factors associated with the development of these complications in patients undergoing myocardial revascularization Methods: 103 consecutive patients with Intra-aortic balloon pump support were evaluated. Univariate and multivariate analyses were performed to identify risk factors for the development of vascular complications. Results: Seven (7%) patients developed major and 8 (8%) patients developed minor vascular complications. Ischaemia of the limb, requiring thromboembolectomy, developed in 2 (3%) patients. Mean age of the patients was 59 ± 2 years and 41% of the patients were female. Vascular complications (leg ischemia) were not affected by age. The overall mortality was 44%. Multiple logistic regression analysis revealed duration of intra-aortic balloon pump support, emergency of operation and diabetes as independent risk factors. The duration of intra-aortic balloon pump therapy ranged from 9 hours to 7 days (mean 2 days) and it had a direct linear relation with occurrence of limb ischemia so that the risk was about 16% of patients per 24h (p = 0.055). prevalence of limb ischemia proved to be higher in diabetic patients (p = 0.04). The emergency of operation had clear impact on leg ischemia in patients with intra-aortic balloon pump (p 0.02).Conclusion: We found no instances of limb ischemia, either minor or major, during the first 24 hours of intra-aortic balloon pump placement, and very importantly, a linear increase in this risk thereafter. Beside other preventive measures to reduce this complication (e.g. . sheathless technique, smaller catheters, anticoagulation ) earlier removal or placement at a different site, optimally before 36 hours after insertion seem prudent specially in high risk groups of patients such as diabetics, those with Body Surface Area (BSA) 1.65 m2, evidences of Peripheral Vascular Disease (PVD) and emergent cases.