title: Current and future applications of the intra-aortic balloon pump.
abstract: OBJECTIVE
  The intra-aortic balloon pump (IABP) has been used for more than 40 years. Although recommended in a wide variety of clinical settings, most of these indications are not evidence-based. This review focuses on studies challenging these traditional indications and evaluates potentially new applications of intra-aortic counterpulsation.
  
  
  RESULTS
  Recent studies have failed to confirm an improvement in clinical outcomes conferred by the IABP in patients developing cardiogenic shock after acute myocardial infarction. This issue is in need of further investigations. While conflicting results of several retrospective studies and meta-analyses have been published regarding the performance of the IABP in high-risk percutaneous coronary interventions, it has recently been found to improve the long-term clinical outcomes of patients in whom it was implanted before the procedure. Small, single-center studies have reported the use of the IABP as a bridge to transplantation or candidacy for left-ventricular assist device implantation. The recently reported feasibility and safety of its insertion via the subclavian or axillary arteries will facilitate these applications.
  
  
  CONCLUSIONS
  The revisiting of available data and the performance of new, thoughtfully designed trials should clarify the proper indications for the IABP.
authors.affiliation: The 3rd Department of Cardiology, University of Athens School of Medicine, Athens, Greece.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Kapelios
authors.forename: John V
authors.initials: JV
authors.lastname: Terrovitis
authors.forename: John N
authors.initials: JN
authors.lastname: Nanas
mesh_terms: D002986:Clinical Trials as Topic; D016027:Heart Transplantation / Q000379:methods*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping / Q000379:methods / Q000706:statistics & numerical data; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology; D017063:Outcome Assessment, Health Care; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D020379:Risk Adjustment; D012770:Shock, Cardiogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy