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Vascular complications of intra-aortic balloon pump (IABP) implantation - a single-center analysis
Session:
Sessão de Posters 04 - Choque cardiogénico
Speaker:
Rui Carlos Gregório Antunes Coelho
Congress:
CPC 2024
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
14. Acute Cardiac Care
Subtheme:
14.4 Acute Cardiac Care – Cardiogenic Shock
Session Type:
Cartazes
FP Number:
---
Authors:
Rui Antunes Coelho; Daniel Caeiro; Marisa Passos Silva; Fábio Nunes; Rafael Teixeira; Marta Ponte; Adelaide Dias; Pedro Braga; Ricardo Fontes de Carvalho
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u><span style="font-size:12.0pt">Background:</span></u></strong> <span style="font-size:12.0pt"><span style="background-color:white"><span style="color:#212121">The intra-aortic balloon pump (IABP) is one of the most commonly used circulatory assist devices in patients in cardiogenic shock after myocardial infarction, in order to both increase coronary blood flow and decrease left ventricular afterload. But the use of the intra-aortic balloon pump (IABP) remains controversial, due to some studies have shown no benefit in end mortality with this device. One of the reasons for this could be the increase in vascular complications when using the IABP.</span></span></span> </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u><span style="font-size:12.0pt">Purpose:</span></u></strong><span style="font-size:12.0pt"> Our aim was</span><span style="font-size:12.0pt"><span style="color:#202124"> evaluate the vascular complications that occurred in patients with IABP and understand if any of the clinical characteristics were associated with the presence of these complications.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><u><span style="font-size:12.0pt">Methods:</span></u></strong><span style="font-size:12.0pt"> We performed a retrospective observational cohort study of all patients that received IABP in two different intensive care units (general and cardiac), from January 2005 up to August 2022.</span></span></span></p> <p><span style="font-size:10pt"><span style="background-color:#f8f9fa"><span style="font-family:"Courier New""><strong><u><span style="font-size:12.0pt"><span style="font-family:"Calibri",sans-serif"><span style="color:black">Results:</span></span></span></u></strong> <span style="font-size:12.0pt"><span style="font-family:"Calibri",sans-serif"><span style="color:#202124">Between January 2005 and August 2022, around 691 IABP were implanted in our institution. Of these, it was possible to assess information about vascular complications in 668. Of the 668 patients analyzed, 31 (4.6%) had significant vascular complications. About 11 patients (1.6%) had significant bleeding, 7 (1.0%) had vascular injury and 13 (1.9%) developed lower limb ischemia. 47 cases (7.0%) reported non-significant complications, such as minor hemorrhage or hematoma at the access local. One case of intra-arterial balloon rupture was reported. Of the clinical features evaluated, only severe impairment of the left ventricular ejection fraction (LVEF) was significantly associated with the occurrence of vascular complications (p = 0.018). The existence of vascular complications is associated with higher in-hospital mortality in patients who underwent IABP implantation (23.4% in the group without vascular complications vs. 41.9% in the group of patients with these complications; p = 0.019). </span></span></span></span></span></span></p> <p><span style="font-size:10pt"><span style="background-color:#f8f9fa"><span style="font-family:"Courier New""><strong><u><span style="font-size:12.0pt"><span style="font-family:"Calibri",sans-serif"><span style="color:black">Conclusions:</span></span></span></u></strong> <span style="font-size:12.0pt"><span style="font-family:"Calibri",sans-serif"><span style="color:#202124">In a population of 668 patients who had IABP implantation, the occurrence of significant vascular complications (lower limb ischemia, vessel wall injury or major bleeding) was observed in 4.6% of cases. The occurrence of these complications has a statistically significant association with severe impairment of the LVEF and higher in-hospital mortality.</span></span></span></span></span></span></p>
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