Vascular complications associated with the use of intraaortic balloon pumping.

Our 11-year experience with intraaortic balloon pumping (IABP) was analyzed to determine the incidence and evaluate the management of vascular complications. Between 1973 and 1984, 637 patients were candidates for IABP. In 41 cases, IABP was precluded because peripheral vascular disease inhibited balloon catheter insertion. Of the 596 patients who underwent IABP, 304 (51.0%) survived the hospital period, and late follow-up information was available for 283 (93%) of these. The late results were analyzed with respect to the duration of survival and the presence of lower-extremity claudication. Sixty-six (11.1%) of the 596 patients experienced vascular complications (mainly in the form of limb ischemia). Balloon removal, followed by thromboembolectomy, restored limb viability in the majority of cases. When continued IABP was required, creation of a femoral-femoral bypass to the portion of the limb distal to the balloon allowed viability to be maintained.