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Current and future applications of the intra-aortic balloon pump

Kapelios, Chris J.; Terrovitis, John V.; Nanas, John N.

Current Opinion in Cardiology: May 2014 - Volume 29 - Issue 3 - p 258–265
doi: 10.1097/HCO.0000000000000059
CARDIAC FAILURE: Edited by Stavros G. Drakos and Nir Uriel

Purpose of review The intra-aortic balloon pump (IABP) has been used for more than 40 years. Although recommended in a wide variety of clinical settings, most of these indications are not evidence-based. This review focuses on studies challenging these traditional indications and evaluates potentially new applications of intra-aortic counterpulsation.

Recent findings Recent studies have failed to confirm an improvement in clinical outcomes conferred by the IABP in patients developing cardiogenic shock after acute myocardial infarction. This issue is in need of further investigations. While conflicting results of several retrospective studies and meta-analyses have been published regarding the performance of the IABP in high-risk percutaneous coronary interventions, it has recently been found to improve the long-term clinical outcomes of patients in whom it was implanted before the procedure. Small, single-center studies have reported the use of the IABP as a bridge to transplantation or candidacy for left-ventricular assist device implantation. The recently reported feasibility and safety of its insertion via the subclavian or axillary arteries will facilitate these applications.

Summary The revisiting of available data and the performance of new, thoughtfully designed trials should clarify the proper indications for the IABP.

The 3rd Department of Cardiology, University of Athens School of Medicine, Athens, Greece

Correspondence to John N. Nanas, MD, PhD, 3rd Department of Cardiology, University of Athens School of Medicine, 67 Mikras Asias Street, 11 527 Athens, Greece. Tel: +30 210 8236877; fax: +30 210 7789901; e-mail:

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