Approximately 20% of patients are unable to receive an intra-aortic balloon pump (IABP) due to aorto-iliac atherosclerotic disease. Aorto-iliac stenoses can be managed with angioplasty or stent placement; however, there are limited data about this strategy to facilitate IABP placement. Thirty-seven IABPs were placed in 35 patients. A total of 45 revascularization procedures were performed. With revascularization, the minimal lumen diameter increased from 2.78 +/- 1.46 to 6.75 +/- 2.36 mm (P < 0.0001). Limb ischemia occurred following 2/37 (5%) IABP insertions. Limb ischemia was managed with IABP removal and angioplasty. The mortality rate was 32%. Mortality was more common with chronic renal insufficiency (8/11, 73%; P = 0.0014), dialysis-dependent renal failure (3/3, 100%; P = 0.028), and presentation with acute myocardial infarction (8/15 patients, 53%; P = 0.036). Although no patients required vascular surgery for limb ischemia, one patient required surgery for bleeding. Angioplasty or stenting to facilitate IABP placement in patients with peripheral vascular disease is safe and effective.
Copyright 2002 Wiley-Liss, Inc.