First Use of an Intra-aortic Balloon Pump as a Bridge Between Surgery for Critical, Symptomatic Carotid and Coronary Disease

Abstract

Introduction The optimal management of concomitant, unstable atherosclerotic coronary and carotid artery disease is unclear. We present the first use of an intra-aortic balloon pump (IABP) as a bridge between carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) in a high-risk patient. Report A 62-year-old man with multiple comorbidities presented with unstable disease in both coronary and carotid territories. He was unsuitable for endovascular management of either lesion. An IABP was used to safely bridge him between carotid and coronary revascularisation. Discussion We propose that where both coronary and carotid circulations are critically compromised, this approach may offer a way out of an otherwise impossible situation.