title: Standard intra-aortic counterpulsation balloon may cause temporary occlusion of mesenterial and renal arteries.
abstract: The study was to test the hypothesis that mesenteric and renal arteries may be occluded by intra-aortic balloon pumps (IABPs), despite correct positioning. Computed tomography scans of 107 patients (34.6% women and 65.4% men) were evaluated for diameter and distance measurements of the descending aorta. Renal perfusion was examined with duplex sonography. Mean distances between left subclavian artery and celiac trunk, between the left subclavian and superior mesenteric artery, and between the left subclavian and renal artery were 214.5 ± 22.3, 229.5 ± 22.3, and 242.9 ± 22.1 mm, respectively. Statistical assessment of aortic distances in patient population showed no correlation between the length of the descending aorta and body mass index (BMI) and height (men: R(2) < 0.13; women: R(2) < 0.3). An impaired arterial perfusion of the renal parenchyma existed in three of the 12 patients; three of the 12 demonstrated diastolic oscillatory flow over the renal arteries; two of the 12 patients presented both during IABP support. Autopsy observation was used to observe the position of the IABP catheter. The correlation between patient height/BMI and the distances between subclavian artery and renal/visceral branches is weak. Therefore, even if positioned correctly, intra-aortic balloon catheters may be too long and could potentially cause occlusion of aortic branches.
authors.affiliation: From the *Heart Center Freiburg University, Center of Cardiovascular Surgery, Freiburg, Germany; †Department of Anesthesiology, and ‡Department of Anesthesiology, and ‡Department of Diagnostic Radiology, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Tetyana
authors.initials: T
authors.lastname: Sukhodolya
authors.forename: Domagoj
authors.initials: D
authors.lastname: Damjanovic
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Beyersdorf
authors.forename: Christoph
authors.initials: C
authors.lastname: Benk
authors.forename: Claudia
authors.initials: C
authors.lastname: Heilmann
authors.forename: Phillip
authors.initials: P
authors.lastname: Blanke
authors.forename: Wulf
authors.initials: W
authors.lastname: Euringer
authors.forename: Georg
authors.initials: G
authors.lastname: Trummer
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000033:anatomy & histology* / Q000601:surgery; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000009:adverse effects* / Q000295:instrumentation; D007668:Kidney / Q000098:blood supply; D008297:Male; D008638:Mesenteric Arteries / Q000473:pathology*; D008875:Middle Aged; D012077:Renal Artery / Q000473:pathology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed