[Immediate and long-term complications of counterpulsation balloon. Recent data apropos of a series of 200 consecutive patients].
The value of intra-aortic balloon counterpulsation as a means of circulatory assistance and of myocardial protection has been widely established, however percutaneous insertion has been associated with a high incidence of complications, reaching 50% in some series. The authors evaluated the immediate and secondary complications of percutaneous insertion under fluoroscopic control of 209 catheters (8.5F to 10.5F) in 200 consecutive patients. The average age was 64 +/- 11 years and 32% were female. The indications of the procedure were: cardiogenic shock (32.5%), high risk coronary angioplasty (19.2%), complications of coronary angioplasty (18.1%), prophylactic insertion before aorto-coronary bypass surgery (13.8%), unstable angina (2%), terminal cardiomyopathy (5.7%), shock (6.7%), others (2%). There were major complications in 10 cases (4.8%): acute lower limb ischaemia requiring surgery (8 cases), bleeding from the femoral artery requiring surgical repair (1 case) and septicaemia (1 case). Minor complications were observed in 19 cases (9%): haematoma (6 cases), lower limb ischaemia reversible with removal of the catheter (10 cases) or with medical treatment (2 cases), superficial infection (1 case). With a mean follow-up of 17 months for 97% of patients, only one false aneurysm of the femoral artery requiring surgery and one case of intermittent claudication were observed. These results suggest that, in operators trained in femoral artery catheterization, the percutaneous insertion of an intra-aortic balloon under fluoroscopic control is justified by the simplicity of the procedure and low rate of complications.
Service de cardiologie, hôpital Charles-Nicolle, Rouen.
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H
Eltchaninoff
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PL
Whitlow
D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization; D003327:Coronary Disease / Q000628:therapy; D015908:Counterpulsation / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery / Q000293:injuries; D005500:Follow-Up Studies; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects* / Q000379:methods; D007511:Ischemia / Q000209:etiology*; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000628:therapy
Complications immédiates et à distance du ballon de contrepulsion intra-aortique percutané. Données récentes à propos d'une série de 200 patients consécutifs.