On-site immediate removal of intraortic balloon pump after high-risk percutaneous intervention with a 6 F closure suture device with the "preclosure" technique.

INTRODUCTION

Intraaortic balloon counterpulsation (IABP) may be necessary during percutaneous intervention (PCI) and sometimes it would be useful to withdraw it at the end of procedure. We describe the utility of a closure suture device to retrieve the IABP in the cardiac catheterization laboratory immediately after the intervention.

METHODS

Observational study of nine consecutive high-risk PCI where an 8.5 F IABP had been retrieved at the end of the procedure with a 6 F Perclose with the "preclosure" technique. The baseline clinical characteristics as well as the in-hospital and 90-days follow-up are described.

RESULTS

The patients age was 67.4 +/- 14.9 years (mean 45-85; three patients were >80; 3 females (33.3%). Left main coronary artery was the target lesion in 8 (88.8%) and 4 (44.4%) patients, performed by radial access. Abciximab was used in 7 patients (77.7%). Successful hemostasis was achieved in all the cases without manual or mechanical compression. Only one patient was transferred to the Coronary Care Unit due to advanced age, left main coronary artery stenting, and severe ventricular dysfunction. Five patients (55.5%) were discharged 24 h after the PCI, three (33.3%) 48 h, and only one remained 72 h after the procedure. There were no events in the 90-days follow-up.

CONCLUSIONS

The "preclosure" technique with the 6 F Perclose is an ingenious approach to achieve successful hemostasis after IABP removal. It may permit to transfer the patients to units without critical care facilities, shorten the admission and reduce vascular complications in patients with peripheral vascular disease who may need the counterpulsation only during the percutaneous intervention.