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Supported High-Risk Cardiac Surgery using an Intra-Aortic Balloon Pump Catheter via the Left Brachial Artery in a Patient Displaying Total Occlusion of the External Iliac Arteries
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  • mio kasai,
  • Kiyoshi Koizumi,
  • Shintaro Nakajima,
  • Koji Funaishi
mio kasai
Japanese Red Cross Ashikaga Hospital
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Kiyoshi Koizumi
Japanese Red Cross Ashikaga Hospital
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Shintaro Nakajima
Japanese Red Cross Ashikaga Hospital
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Koji Funaishi
Japanese Red Cross Ashikaga Hospital
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Abstract

The intra-aortic balloon pump (IABP) was first successfully used by Kantrowitz and colleagues in 1968 . Traditionally, IABPs are inserted via the femoral artery. However, this approach is usually contraindicated in patients with severe peripheral vascular disease (PVD). Noël and colleagues were the first to report transbrachial insertion of an 8 Fr IABP catheter for ventricular assistance during percutaneous coronary intervention. However, in almost all the reported cases in which transbrachial insertion of an IABP was performed, it was done for hemodynamic support during percutaneous coronary intervention or coronary artery bypass grafting. We present a case involving a patient with endocarditis-associated structural aortic valve deterioration and severe left ventricular dysfunction, as well as total occlusion of both external iliac arteries. The patient was successfully treated using a 7 Fr transbrachial IABP. A left transbrachial percutaneous approach may thus be a safe and effective alternative if femoral artery access cannot be achieved.