Intra-aortic balloon counterpulsation (IABC) has long been the preferred method for mechanically supporting blood circulation. This method is characterized by clinical efficacy, good safety indicators for various treatment regimens, as well as low cost.
What is it?
IABC is a medical technique that is used for cardiogenic shock in patients with acute left ventricular failure and consists in mechanically pumping blood into the aorta using special medical equipment (pump) during diastole, which helps to increase blood flow in the coronary arteries and provides temporary support of the pumping function of the ventricle.
The technique was first proposed in 1962 and used in a clinic in 1968 by Adrian Kantrowitz in the treatment of a patient with cardiogenic shock.
Procedure
- A device with a polyurethane balloon is inserted through the femoral artery;
- The balloon is held up to the aortic arch under radiological control and is installed below the left subclavian artery;
- By periodically inflating and deflating the balloon in accordance with the phases of the cardiac cycle, temporary support of the pumping function of the heart is provided.
Indications
- Cardiogenic shock due to myocardial infarction;
- Unstable angina pectoris;
- Conditions after cardiac surgery;
- Preoperative preparation in high-risk patients;
- Percutaneous coronary angioplasty, etc.
Contraindications
Absolute:
- Severe aortic valve insufficiency;
- Rupture of the aorta;
- Severe ileal artery thrombosis.
Relative:
- The presence of vascular prostheses in the aorta;
- Aortic aneurysm;
- Grafts of the aorto-femoral segment.
Possible complications
- Ischemia of the lower extremity during the injection of the balloon through the femoral artery;
- Renal artery occlusion and kidney damage when placing the balloon too distally from the aortic arch;
- Brain embolism;
- Infectious complications;
- Rupture of the aorta or iliac artery;
- The entry of small blood clots into the bloodstream;
- Peripheral organ thrombosis.