Long-term follow-up of limbs after use of intra-aortic balloon counterpulsation device.

ABSTRACT

There has been concern for the viability and function of the limb distal to the femoral artery access site after use of the intra-aortic balloon counterpulsation device (IABCD). We have studied the long-term (6 to 50 months) hemodynamic status in the lower limbs of 31 patients who received circulatory support with the IABCD. Since both limbs were classified according to the pressure changes induced by treadmill walking, comparisons with the unoperated leg could be affected. Nine of ten patients with insertion problems had satisfactory results at follow-up. One limb was lost as a result of the use of IABCD. Two patients had required femorofemoral bypass, three required use of the opposite leg because of gross femoral disease, one required thrombectomy, three lost distal pulses, and one developed groin phlebitis. All these patients (except the one requiring amputation) had satisfactory hemodynamics at follow-up. Of the 21 patients with no insertion problems, all had satisfactory hemodynamics at follow-up, and 16 of the 21 were normal. Three patients had better hemodynamic data in the balloon-access limb than in the contralateral limb at follow-up, suggesting that the surgery may have been salutary. We conclude that placement of the IABCD via the common femoral artery does not alter the long-term function of the ipsilateral limb if perioperative problems are avoided or handled appropriately.