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
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.