Vascular Complications after Intra-aortic Balloon Pump Insertion Are Rare Events

With great interest, we read the article of Yuksel et al regarding vascular complications of the intra-aortic balloon pump (IABP) insertion.[1] They report an early vascular complication rate of 8.7% in 148 IABP patients over a time period from 2002 to 2011. Unfortunately, the authors did not cite several articles describing a far lower complication rate between 1.2 and 3.7%.[2] [3] [4] After acceptance of the author's article, we published an article on the same subject,[5] showing a very low incidence of vascular complications with the same modern insertion techniques described by Yuksel et al. We did a meticulous 5-year follow-up of the surviving IABP patients and found that only 5 out of 97 patients had a clinically relevant arterial stenosis on the same side as the IABP implantation. Of these five patients, four already had the diagnosis “peripheral arterial disease” before IABP implantation. Only 1 out of 97 patients showed a new-onset arterial perfusion problem at the site of IABP insertion.

Taking the mentioned references into account, the conclusion of Yuksel et al “Incidence of vascular complications in IABP counterpulsation is still a problem…” seems not justified.

• References

• 1 Yuksel V, Huseyın S, Ozdemır AC, Ege T. Vascular complications of the intra-aortic balloon pump in patients undergoing open heart surgery: 10 year's experience. Thorac Cardiovasc Surg 2013; 61 (5) 453-455
• 2 Dick P, Mlekusch W, Delle-Karth G, Nikfardjam M, Schillinger M, Heinz G. Decreasing incidence of critical limb ischemia after intra-aortic balloon pump counterpulsation. Angiology 2009; 60 (2) 235-241
• 3 Santarpino G, Onorati F, Rubino AS , et al. Preoperative intraaortic balloon pumping improves outcomes for high-risk patients in routine coronary artery bypass graft surgery. Ann Thorac Surg 2009; 87 (2) 481-488
• 4 Dyub AM, Whitlock RP, Abouzahr LL, Cinà CS. Preoperative intra-aortic balloon pump in patients undergoing coronary bypass surgery: a systematic review and meta-analysis. J Card Surg 2008; 23 (1) 79-86
• 5 Böning A, Buschbeck S, Roth P , et al. IABP before cardiac surgery: clinical benefit compared to intraoperative implantation. Perfusion 2013; 28 (2) 103-108

• Reference

• 1 Yuksel V, Huseyın S, Ozdemır AC, Ege T. Vascular complications of the intra-aortic balloon pump in patients undergoing open heart surgery: 10 year's experience. Thorac Cardiovasc Surg 2013; 61 (5) 453-455