title: IABP-Related vascular complications: who is responsible--the patient, the surgeon or the sheath? Part I: sheath-related complications.
abstract: BACKGROUND
  An intra-aortic balloon pump (IABP) is frequently used as a mechanical support during the treatment of low cardiac output syndrome. The use of a sheath during IABP treatment can be associated with ischaemic complications in the extremities. The aim of our study was to determine the isolated role of sheaths in the development of vascular complications following IABP catheterisation.
  
  
  METHODS
  We evaluated a total of 81 patients who had received an IABP for haemodynamic stability, between January 2003 and October 2007, following cardiovascular surgery. To eliminate surgical-related variables, only patients with IABPs and size 8.5 or 9 French catheters (inserted by experienced cardiovascular surgeons using the percutaneous Seldinger technique) were included in the study. To eliminate patient-related variables, patients with a known risk factor for either thrombosis, embolus or peripheral arterial disease were excluded from the study.
  
  
  RESULTS
  The patients were divided into two groups: Group 1 (sheathed catheter group; n=42), Group 2 (sheathless catheter group; n=39). Ischaemic complications were observed in a total of five patients. Four of these patients were from Group 1 and one was from Group 2.
  
  
  CONCLUSIONS
  Sheathed catheterisation was found to increase the risk of vascular complications in patients who underwent IABP application. Therefore sheathless catheterisation is recommended for IABP application.
authors.affiliation: Department of Cardiovascular Surgery, Medical Faculty, Kocatepe University, Afyon, Turkey. cevdetkoc@hotmail.com
authors.forename: Cevdet Ugur
authors.initials: CU
authors.lastname: Kocogullari
authors.forename: Mustafa
authors.initials: M
authors.lastname: Emmiler
authors.forename: Ercument
authors.initials: E
authors.lastname: Ayva
authors.forename: Ahmet
authors.initials: A
authors.lastname: Cekirdekct
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000295:instrumentation*; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged