Complications of intraaortic balloon counterpulsation insertion in patients receiving thrombolytic therapy for acute myocardial infarction.
This study retrospectively examines 38 patients who presented with acute myocardial infarction requiring intraaortic balloon pump counterpulsation.  Two groups of patients were identified.  Group I consisted of patients with acute myocardial infarction treated with intraaortic balloon pump without thrombolytic therapy.  Group II consisted of patients treated with intraaortic balloon pump after receiving intravenous thrombolytic therapy.  These groups were compared and contrasted with regard to previously identified complications associated with intraaortic balloon pump counterpulsation including loss of limb and mortality.  The need for surgery, embolectomy, and drainage of hematoma were also evaluated.  The need for surgery in group II (11%) and in both groups combined (7%) is lower than is generally reported in literature (range 11.6% to 34%).  In addition, no patients experienced a loss of limb and no patients in the study had severe life-threatening iatrogenic morbidity or mortality.  While mortality was not an end point in this study, it was noted that there was an increased survival rate in group II patients with 61% surviving until the time of hospital discharge.  Also, eight out of 14 patients in group II who underwent intraaortic balloon pump counterpulsation for cardiogenic shock survived until the time of discharge.  This represents a 57% survival rate for patients presenting with cardiogenic shock.  We conclude that intraaortic balloon pumps can be inserted safely following thrombolytic therapy in a community hospital.
Silverman
A J
AJ
Botsford General Hospital, Farmington Hills, Michigan.
Williams
A M
AM
Wetmore
R W
RW
Stomel
R J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015908:Counterpulsation / Q000009:adverse effects*; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D013300:Streptokinase / Q000627:therapeutic use; D015912:Thrombolytic Therapy; D016896:Treatment Outcome