Transbrachial Intraaortic Balloon Pumping in Severe Peripheral Atherosclerosis

Preoperative intraaortic balloon pumping improves the results of complex coronary surgery; however, insertion may be harmful or contraindicated in severe and diffuse atherosclerosis of the descending aorta and peripheral arteries. We report our experience with 10 consecutive patients with severe peripheral atherosclerosis or distal abdominal aortic aneurysms, in whom a 7.5F intraaortic balloon catheter was inserted through the brachial artery. Intraaortic balloon pumping was maintained until hemodynamic stability was established; no complications or ischemia of the hand related to the intraaortic balloon pump occurred. Transbrachial intraaortic balloon pumping with a 7.5F catheter is as safe and effective as the transfemoral method in patients with unavailable femoral arteries. © 2007 The Society of Thoracic Surgeons.