A New Method to Prevent Ischemia of the Distal Extremity During Intraaortic Balloon Pump

Intraaortic balloon pumping (IABP) is stili the most common assist circulatory support system. One of the serious potential complications of this system is limb ischemia. A 64-year-old patient who underwent coronary bypass surgery developed ischemia on the IABP-applied Iimb, and the device, was tried to be transferred to the other extremity. Because this trial failed and the patient stili needed circulatory support, the IABP was again applied on the same limb. Distal perfusion was accomplished by using two 16 G catheters in each femoral artery which were connected with an extension tube used for the arterial pressure monitorization, and a blood flow of 90 ml/min was achieved. Signs of ischemia disappeared with the help of this system. Since the patient needed no futher circulatory support, intraaortic pumping and distal perfusion was terminated after fifteen hours. After insertion of IABP, if the transfer of the balloon to the other limb is not feasible, this is an easy and effective method.