Göl M K, Bayazit M, Emir M, Taşdemir O, Bayazit K
Cardiovascular Surgery Department, Türkiye Yüksek Ihtisas Hospital, Ankara.
Ann Thorac Surg. 1994 Nov;58(5):1476-80. doi: 10.1016/0003-4975(94)91939-9.
The hemodynamic effects of intraaortic balloon pumps (IABPs) are well known. The use of IABPs is prone to many complications, including those classified as vascular. These complications are said to be more frequent with percutaneous insertion techniques. These complications and the algorithm for identifying patients who are most likely to suffer vascular complications were evaluated in a retrospective manner in a group of patients that received percutaneous IABPs. The study group consisted of 449 patients. The mean age of these patients was 53.6 +/- 12.8 years (range, 18 to 80 years), and 24.7% were female. The early mortality rate of these patients was 53.2%. The mortality for patients in whom vascular complications developed was significantly higher than that in the patients who did not suffer any vascular complications (65.7% versus 50.8%; p = 0.018). Minor or major vascular complications developed in 17.4% (n = 78) of the patients. There was no statistical difference in the frequency of complications between the patients who received a sheathless IABP and those who received a sheathed IABP. Ischemic complications occurred in 16.6% of the patients who received a sheathless IABP and in 17.6% of the patients with sheathed IABPs (p < 0.05). Diabetic patients (relative risk, 2.5), female patients (relative risk, 1.83), patients with peripheral vascular disease (relative risk, 3.69), and patients undergoing coronary artery bypass operations (relative risk, 2.08) were at increased risk for suffering vascular complications. These risk factors should be evaluated before insertion of an IABP, and routes other than percutaneous femoral insertion are preferred if the patient is IABP dependent.
主动脉内球囊反搏泵（IABP）的血流动力学效应众所周知。IABP的使用容易引发许多并发症，包括那些归类为血管方面的并发症。据说经皮插入技术引发这些并发症的频率更高。在一组接受经皮IABP治疗的患者中，以回顾性方式评估了这些并发症以及识别最有可能发生血管并发症患者的算法。研究组由449名患者组成。这些患者的平均年龄为53.6±12.8岁（范围为18至80岁），女性占24.7%。这些患者的早期死亡率为53.2%。发生血管并发症患者的死亡率显著高于未发生任何血管并发症的患者（65.7%对50.8%；p = 0.018）。17.4%（n = 78）的患者发生了轻微或严重的血管并发症。接受无鞘IABP的患者与接受有鞘IABP的患者在并发症发生频率上无统计学差异。接受无鞘IABP的患者中有16.6%发生缺血性并发症，接受有鞘IABP的患者中有17.6%发生缺血性并发症（p < 0.05）。糖尿病患者（相对风险为2.5）、女性患者（相对风险为1.83）、外周血管疾病患者（相对风险为3.69）以及接受冠状动脉搭桥手术的患者（相对风险为2.08）发生血管并发症的风险增加。在插入IABP之前应评估这些风险因素，如果患者依赖IABP，除经皮股动脉插入之外的其他途径更可取。
