Significant vascular complications in percutaneous axillary intra-aortic balloon pump

Ann Vasc Surg. 2022 Jul:83:42-52. doi: 10.1016/j.avsg.2021.12.078. Epub 2022 Jan 5.


Objective: Axillary Intra-aortic balloon pump (IABP) has been increasingly utilized for hemodynamic support in heart failure patients. Vascular complications associated with axillary IABP such as dissection or rupture are relatively rare but not negligible that could negatively affect clinical outcomes. We summarized our experiences.

Methods: This is a retrospective study reviewing of all patients receiving an axillary IABP between June 2016 and November 2020. A total of 199 patients underwent percutaneous axillary IABP placement. 6 patients (6/199, 3.0%) were complicated with arterial/aortic dissection or rupture during the procedures or the course of treatment. We described their clinical presentations and outcomes.

Results: Vascular complications included acute type A aortic dissection in 2 patients, descending aortic rupture in 1 patient, abdominal aortic rupture along with type B aortic dissection in 1 patient, and the localized left subclavian artery dissection in 2 patient. 2 type A aortic dissection cases were surgically treated: 1 with emergent left ventricle assist device and ascending aorta replacement, the other with emergent left ventricle assist device. Emergent endovascular treatment was successfully performed in 2 aortic rupture cases. The left subclavian artery dissection cases were managed medically. The postoperative/treatment course was uneventful in all patients.

Conclusion: Percutaneous axillary IABP therapy can cause significant vascular complications. Early diagnosis and prompt treatment would be the key to improve the clinical outcomesv.

MeSH terms

  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / surgery
  • Aortic Rupture* / diagnostic imaging
  • Aortic Rupture* / etiology
  • Aortic Rupture* / surgery
  • Heart-Assist Devices* / adverse effects
  • Humans
  • Retrospective Studies
  • Treatment Outcome