Learning Radiology xray montage

Intra-aortic Counterpulsation Balloon Pump


Why are they used

  • Used to improve cardiac output and improve perfusion of the coronary arteries following surgery or in patients with cardiogenic shock or refractory ventricular failure. 

  • Placed in the proximal descending thoracic aorta, the balloon is inflated in diastole and deflated in systole.

Correct placement of intra-aortic balloon pumps

  • Tip can be identified by small, linear metallic marker

    • The tip should lie distal to origin of the left subclavian artery so as not to occlude it.

    • Metallic marker may point slightly toward the right in region of aortic arch.

  • When inflated, the sausage-shaped balloon may be visualized as an air-containing structure in the descending thoracic aorta.

Incorrect placement and complications of intra-aortic balloon pumps

  • If catheter is too proximal, the balloon may occlude the great vessels leading to stroke.

  • If the balloon is too distal, the device has decreased effectiveness.

  • Aortic dissection and arterial perforation may occur infrequently 

 intra aortic balloon pump, iabp

Intra-aortic Balloon Pump. The tip (red arrow) is marked by a linear metallic density. It should lie about 2 cm from the top of the aortic arch, just distal to the origin of the left subclavian artery.