The Journal of Thoracic and Cardiovascular Surgery, Vol 103, 569-572, Copyright © 1992 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
A prospective randomized study comparing surgical and percutaneous removal of intraaortic balloon pump
MJ Rohrer, CA Sullivan, DJ McLaughlin and BS Cutler
Division of Vascular Surgery, University of Massachusetts Medical Center, Worcester 01655.
This prospective randomized study of 50 patients compares the prevalence of
complications between surgical and percutaneous methods of removal of
intraaortic balloons. All patients who had percutaneous placement of a 9.5F
intraaortic balloon during a 6-month period were eligible for the study.
Patients were excluded if the intraaortic balloon was placed surgically, if
a coagulopathy was present, or if acute leg ischemia developed at any time
after insertion. After informed consent, 25 patients were randomized to
each method of removal. Two complications occurred in the surgical group,
including a wound infection and a lymph fistula. In one patient in the
percutaneous group, a false aneurysm of the femoral artery developed. There
was no significant difference between the mean of 59 minutes for
percutaneous removal and 47 minutes for operative removal of the balloon (p
= 0.74). The percutaneous method is therefore more cost-effective, because
it does not require the use of operating room personnel or equipment
necessary for surgical removal. The results of this study indicate that the
majority of percutaneously placed intraaortic balloons may be safely
removed percutaneously. Surgical removal of 9.5F intraaortic balloons is
recommended for patients with bleeding diatheses, hemorrhagic or ischemic
complications, or for those in whom the intraaortic balloon was inserted
with a surgical procedure.
