Percutaneous Axillary Intra-aortic Balloon Pump Insertion Technique as Bridge to Advanced Heart Failure Therapy

Andrew N. Rosenbaum, C. Charles Jain, Ilya Y. Shadrin, Stephanie C. El Hajj, Abdallah El Sabbagh, Atta Behfar

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


In patients with advanced heart failure (HF), temporary mechanical circulator support (TMCS) is used to improve hemodynamics, via left ventricular unloading, and end-organ function as a bridge to definitive therapy. While listed for cardiac transplantation, use of TMCS may be prolonged, preventing adequate mobility. Here, we describe the technique for placement of a percutaneous axillary intra-aortic balloon pump (IABP) using single-site arterial access to facilitate ambulation and subsequent safe removal without surgery or a closure device. Retrospective review of the experience with this approach at a single institution between September 2017 and February 2020 documented feasibility and safety. Baseline demographics, hemodynamic data, and clinical outcomes were collected. Thirty-eight patients had a total of 56 IABPs placed. There were no significant access site or cerebrovascular complications. One fifth of IABPs (21.4%) had balloon failure or migration, requiring placement of a new device, though no patients had significant complications from balloon failure. The majority (81.6%) of patients in the cohort on axillary IABP support were ambulatory and ultimately received the intended therapy (63.2% transplant, 13.2% durable left ventricular assist device, 5.3% other cardiac surgery). Percutaneous, axillary IABP is feasible and associated with an acceptable complication rate as a bridge to definitive therapy.

Original languageEnglish (US)
Pages (from-to)E81-E85
JournalASAIO Journal
Issue number4
StatePublished - Apr 1 2021


  • heart failure
  • intra-aortic balloon pump technique
  • mechanical support
  • percutaneous

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering


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