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主动脉内球囊反搏植入术后的血管并发症:最新综述

Vascular complications following intra-aortic balloon pump implantation: an updated review.

作者信息

de Jong Monique M, Lorusso Roberto, Al Awami Fatima, Matteuci Francesco, Parise Orlando, Lozekoot Pieter, Bonacchi Massimo, Maessen Jos G, Johnson Daniel M, Gelsomino Sandro

机构信息

1 Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht-CARIM, Maastricht, The Netherlands.

2 Section of Cardiac Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

出版信息

Perfusion. 2018 Mar;33(2):96-104. doi: 10.1177/0267659117727825. Epub 2017 Aug 17.

Abstract

BACKGROUND

The use of the intra-aortic balloon pump (IABP) as a support device remains controversial due to the fact that a number of studies have shown no benefit in end mortality whilst using this device. One of the reasons for this could be the increase in vascular complications when using the pump. Therefore, the aim of the present review was to assess the current literature available with regards to IABP vascular complications during the clinical situation.

METHODS

A literature search was performed, searching for IABP complications in adult human studies between 1990 and 2016.

RESULTS

A total of 20 reports were identified as fitting the criteria of this study. The majority of vascular complications were limb ischemia, bleeding or mesenteric ischemia. The overall incidence of vascular complications ranged from 0.94% to 31.1%. Diabetes, peripheral vascular disease and hypertension, as well as smoking were all identified as risk factors for complications following IABP. Furthermore, studies supported the use of sheathless balloon insertion to reduce the risk of complications.

CONCLUSION

Major vascular complications, including limb and mesenteric ischemia as well as bleeding and hemorrhage, have been associated with IABP. However, the incidence of these complications was generally low. Further studies are still required to truly understand the risk/benefit associated with the use of IABP.

摘要

背景

主动脉内球囊反搏泵(IABP)作为一种支持装置的应用仍存在争议,因为许多研究表明在使用该装置时对最终死亡率并无益处。造成这种情况的原因之一可能是使用该泵时血管并发症会增加。因此,本综述的目的是评估当前有关临床情况下IABP血管并发症的文献。

方法

进行文献检索,查找1990年至2016年间成人人体研究中的IABP并发症。

结果

共确定了20篇符合本研究标准的报告。大多数血管并发症为肢体缺血、出血或肠系膜缺血。血管并发症的总体发生率在0.94%至31.1%之间。糖尿病、外周血管疾病、高血压以及吸烟均被确定为IABP术后并发症的危险因素。此外,研究支持使用无鞘球囊插入术以降低并发症风险。

结论

主要血管并发症,包括肢体和肠系膜缺血以及出血和大出血,均与IABP有关。然而,这些并发症的发生率总体较低。仍需要进一步研究以真正了解使用IABP的风险/益处。

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