The Journal of Thoracic and Cardiovascular Surgery, Vol 81, 297-301, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Randomized comparison of the modified wire-guided and standard intra- aortic balloon catheters
DC Lundell, GL Hammond, AS Geha, H Laks and S Wolfson
We have designed a modified intra-aortic balloon (IAB) catheter to
facilitate balloon insertion and minimize the complications of vascular
dissection, perforation, and thrombosis. The modified balloon catheter is
fabricated of a new polyurethane, Avcomat-100; it has a central lumen which
allows for pressure monitoring, contrast injection, and introduction of a
guide-wire under fluoroscopic control. In a randomized study, we compared
the modified balloon with the standard Avco balloon catheter. Eighteen
patients were randomized, 10 to receive a standard balloon catheter
(control group) and eight to receive a modified balloon catheter. In two of
the 10 patients assigned to the control group, introduction of the standard
catheter failed but a central-lumen balloon was successfully introduced
using the guide wire. A guide wire was needed for introduction of the
modified balloon in three of the eight patients assigned to the
central-lumen catheter group. The Avcomat-100 catheter material was less
thrombogenic, with a lower rate of femoral thrombosis--20% in the control
group and 0% in the central-lumen group. Scanning electron miroscopy also
showed a reduced area of catheter surface covered with fibrin and clot.
This study demonstrates the safety, decreased thrombogenicity, and
increased facility of insertion of this new balloon catheter.
