Identification of patients at high risk for complications of intraaortic balloon counterpulsation: A multivariate risk factor analysis

• Published in: The American journal of cardiology Vol. 53; no. 8; pp. 1135 - 1139
• Main Authors: Gottlieb, Sidney O., Brinker, Jeffrey A., Borkon, A.Michael, Kallman, Clayton H., Potter, Alan, Gott, Vincent L., Baughman, Kenneth L.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.1984; Elsevier
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Assisted Circulation - adverse effects; Biological and medical sciences; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Factor Analysis, Statistical; Female; Humans; Intensive care medicine; Intermittent Claudication - complications; Intra-Aortic Balloon Pumping - adverse effects; Ischemia - etiology; Male; Medical sciences; Middle Aged; Risk; Vascular Diseases - etiology; Cuffed tube; Aorta; Contrepulsation
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(84)90650-7

Risk factors for vascular complications of intraaortic balloon (IAB) counterpulsation were evaluated in 206 consecutive patients. The approach was percutaneous in 105 patients and surgical cutdown in 101. Vascular complications occurred in 42 patients, and of these 21 required surgery. Multivariate analysis demonstrated the following major risk factors for vascular complications: preexisting peripheral vascular disease (PVD) defined as a history of claudication, femoral bruit or absent pedal pulse (p <0.01); and the use of the percutaneous approach (p = 0.02). Evidence of PVD was particularly predictive of major vascular complications requiring surgery (p <0.01). In patients with evidence of previous PVD, the risk for a major vascular complication was 31% with the percutaneous, and 16% with the surgical cutdown approach. Without PVD, the risk for a major vascular complication was 4 times higher in women (15 %) than in men (3.5 %), but in the presence of PVD gender had no significant effect (p = 0.03). Age, duration of IAB counterpulsation and indication for insertion were not significant risk factors. It is concluded that (1) without previous PVD, women are at greater risk than men for major vascular complications (due to smaller arterial size); and (2) evidence of previous PVD identifies patients at high risk for major vascular complications with IAB counterpulsation, particularly by way of the percutaneous approach.