Shahian D M, Neptune W B, Ellis F H, Maggs P R
Ann Thorac Surg. 1983 Dec;36(6):644-53. doi: 10.1016/s0003-4975(10)60273-1.
We reviewed our concurrent experience with percutaneous insertion versus surgical placement of the intraaortic balloon pump over a two-year period both to compare morbidity and to provide guidelines for the choice of method in particular patient groups and clinical settings. The effects on morbidity of sex, age, emergency placement, coexisting peripheral vascular disease, and duration of counterpulsation were determined. Sex was a highly significant factor, with low complication rates (3/29 or 10.3%) for percutaneous insertion in men and an inordinately high morbidity (12/17 or 70.6%) in women (Fisher exact test: p = 4.611 X 10(-5)). This difference may be due to the smaller size of the femoral artery in women. We conclude that percutaneous insertion is the preferred technique for most men but that direct exposure of the femoral artery should be employed in women. Given the serious morbidity encountered with each technique, there is no justification to broaden the indications for intraaortic balloon counterpulsation.
我们回顾了两年间经皮插入与手术放置主动脉内球囊泵的同期经验，以比较发病率，并为特定患者群体和临床环境中方法的选择提供指导。确定了性别、年龄、紧急放置、并存的外周血管疾病以及反搏持续时间对发病率的影响。性别是一个非常显著的因素，男性经皮插入的并发症发生率较低（29例中有3例，占10.3%），而女性的发病率极高（17例中有12例，占70.6%）（Fisher精确检验：p = 4.611×10⁻⁵）。这种差异可能是由于女性股动脉较细。我们得出结论，经皮插入是大多数男性的首选技术，但女性应采用股动脉直接暴露法。鉴于每种技术都存在严重的发病率，没有理由扩大主动脉内球囊反搏的适应症。
