Hedenmark J, Ahn H, Henze A, Nyström S O, Svedjeholm R, Tydén H
Department of Anesthesiology, University Hospital, Uppsala, Sweden.
Scand J Thorac Cardiovasc Surg. 1988;22(2):123-5. doi: 10.3109/14017438809105941.
During a 5-year period, intra-aortic balloon pumping (IABP) was performed on 90 patients (3.1% of those undergoing open-heart surgery), using a Percor catheter inserted with Seldinger technique. Overall prognosis was poor; only 46 of the 90 patients were alive at postoperative follow-up averaging 23 months. Limb ischemia arose in 20%, with incidence uninfluenced by catheter insertion technique (percutaneous v. 'open'). Surgical treatment was required for half of the ischemic limbs. Groin hematoma commonly followed percutaneous extraction of IABP catheter, whereas 'open' removal was always hemostatic, with potential for embolectomy. Percutaneous insertion of IABP catheter via the femoral artery is the method of choice in an emergency situation. 'Open' Seldinger technique is preferable in the operating room. For elective IABP catheter removal, the 'open', hemostatic technique is recommended. If limb-threatening ischemia develops, the catheter must be removed. If the patient is IABP-dependent, the contralateral femoral artery or the ascending aorta should be considered as an alternative catheter route.
在5年期间，对90例患者（占接受心脏直视手术患者的3.1%）进行了主动脉内球囊反搏（IABP）治疗，采用经皮穿刺技术插入Percor导管。总体预后较差；90例患者中只有46例在术后平均23个月的随访中存活。肢体缺血发生率为20%，其发生率不受导管插入技术（经皮插入与“开放”插入）的影响。半数缺血肢体需要手术治疗。经皮拔除IABP导管后常出现腹股沟血肿，而“开放”拔除总能止血，且有进行栓子切除术的可能。在紧急情况下，经股动脉经皮插入IABP导管是首选方法。在手术室中，“开放”的Seldinger技术更可取。对于择期拔除IABP导管，建议采用“开放”的止血技术。如果发生威胁肢体的缺血，必须拔除导管。如果患者依赖IABP，应考虑对侧股动脉或升主动脉作为替代导管插入途径。
