Unique Complications Associated with Patient Ambulation in the Setting of Percutaneous Axillary Intra-Aortic Balloon Pump

Introduction We had previously published a percutaneous technique of axillary intra-aortic balloon pump (IABP) placement in patients being bridged to transplant for facilitation of ambulation and physical recovery. However, this enhanced mobility of the patient may predispose to a higher risk of IABP malposition with unique complications compared to the non-ambulatory state of femoral IABP therapy. We present our experience to illustrate this. Methods We conducted a retrospective chart review of patients that received percutaneous axillary IABP at our hospital from October 2015 to February 2018. Results A total of 75 patients had percutaneous axillary IABP insertion during the study period. Of these, 2 had gross IABP malposition into the arch of aorta and 5 patients had superior mesenteric artery (SMA) occlusion by IABP. Table 1 describes the specifics of these patients. Conclusion There has been a wealth of experience with femoral IABP use wherein the malpositions described above have not been reported. As utilization of IABP in the axillary position to promote ambulation is increasing, it is imperative to understand and expect such unique complications for prompt diagnosis and management.