Is percutaneous insertion of the intra-aortic balloon pump through the femoral artery the safest technique?

Between Jan. 1, 1979, and Sept. 30, 1983, 423 intra-aortic balloon pumps (IABPs) were successfully inserted into 400 patients; IABPs could not be inserted in 36 patients (success rate 91.7%). Before 1980 all balloons were inserted surgically through a graft and by 1983 virtually all IABPs were inserted by percutaneous techniques. Infectious complications occurred in 12.3% of IABPs inserted by the open technique and 1.5% of IABPs inserted percutaneously (p less than 0.001). Major ischemic complications were not significantly different between the two groups when all of the patients were analyzed together (p greater than 0.5) and when only the surviving patients were analyzed (p greater than 0.75). However, ischemic complications occurred in 32.9% of women in the study and only 19.7% of the men (p less than 0.005). The percutaneous insertion of the IABP is recommended as the technique of choice because of the ease of insertion, lack of infectious complications, and similar rate of major ischemic complications when compared with IABPs inserted by open surgical means through a graft anastomosed to the common femoral artery.