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The Science Behind IABP Therapy

This on-demand webinar will enhance your knowledge of the physiological and clinical effects as well as the therapeutic rationale for intra-aortic balloon pump therapy. 

 

MCS device selection in HF patients - Where does counterpulsation fit?

This video session focuses on the unique physiological effects of counterpulsation in advanced heart failure patients. Moreover, the session provides guidance on MCS selection based on underlying etiology, clinical phenotyping, and predictors for positive hemodynamic and clinical response. Finally, you will be presented with novel applications for counterpulsation in HF.

SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies

Since 2019, the SCAI SHOCK stage classification has been widely adopted and subsequently validated by multiple groups across the spectrum of CS. The SCAI SHOCK consensus workgroup reviewed the validation studies in detail to identify potential areas of refinement for the classification scheme.

Influence of intra-aortic balloon pump on mortality as a function of cardiogenic shock severity

IABP use was associated with substantially lower in-hospital mortality in patients with CS, without differences in this effect across the SCAI shock stages.

Fiber-optic Balloons from Getinge

Fiber-Optic Balloons

Faster set-up compared to conventional IABs with no need to level and zero the arterial line, simplified pressure monitoring with in vivo calibration.[3] 

Graphic illustration of large volume balloon used in IABC procedures, Getinge

Large Volume Balloons

Patients of various sizes can receive greater hemodynamic support evidenced by more blood volume displacement, more diastolic augmentation, and more systolic unloading when compared to conventional sized balloons.[4],[5]

Studies support low rates of vascular and bleeding complications in IABP therapy.[6]

IABP therapy, as demonstrated in numerous randomized trials, has been shown to exhibit a low incidence of major bleeding or vascular complications.[6],[7],[8],[9]

Trial​

IABP​

No IABP​

P value​

BCIS-1[7] major bleeding​ 3.3%​ 4.0%​ 0.77​
CRISP AMI[8] major bleeding​ 3.1%​ 1.7%​ 0.49​
CRISP AMI[9] major vascular​ 4.3%​ 1.1%​ 0.09​
IABP-SHOCK II[9] moderate bleeding​ 17.3%​ 16.4%​ 0.77​
IABP-SHOCK II[9] major bleeding​ 3.3%​ 4.4%​ 0.51​
IABP-SHOCK II[9]  major vascular​ 4.3%​ 3.4%​ 0.53​
  1. 1. Jiritano F, et al. Temporary Mechanical Circulatory Support in Acute Heart Failure. Card Fail Rev. 2020 Mar 16;6:e01.

  2. 2. Tam, Christopher W.; Shen, Liang; Zeidman, Amanda Dijanic; Srivastava, Ankur; Ivascu, Natalia S.. Mechanical Circulatory Support: Primer for Consultant Specialists. CJASN 17(6):p 890-901, June 2022.

  3. 3. Yarham G, Clements A, Morris C, et al. Fiber-optic intra-aortic balloon therapy and its role within cardiac surgery. Perfusion. 2012;28(2):97-102.

  4. 4. Kapur,NK, et al. Hemodynamic Effects of Standard vs Larger-Capacity Intraaortic Balloon Counterpulsation Pumps JIC 2015;27 (4):182-188

  5. 5. Baran DA, et al. Differential responses to larger volume intra-aortic balloon counterpulsation: Hemodynamic and clinical outcomes. Catheter Cardiovasc Interv. 2018;92(4):703-710

  6. 6. Manshadi SD, et al. Vascular Complications With Intra-aortic Balloon Pump (IABP): Experience From a Large Canadian Metropolitan Centre. Can J Cardiol. 2022;4(11):989-993.

  7. 7. Perera, D., et al. (2010). Elective intra-aortic balloon counterpulsation during high-risk percutaneous coronary intervention: a randomized controlled trial. JAMA, 304(8), 867-874.

  8. 8. Patel MR, Smalling RW, Thiele H, et al. Intra-aortic Balloon Counterpulsation and Infarct Size in Patients With Acute Anterior Myocardial Infarction Without Shock: The CRISP AMI Randomized Trial. JAMA. 2011;306(12):1329–1337.

  9. 9. Thiele, H., et al. (2012). Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock. New England Journal of Medicine, 367(14), 1287–1296.