Potential Risk for Intra-Aortic Balloon-Induced Obstruction to the Celiac Axis or the Renal Artery in the Asian Population

Abstract

To evaluate the potential risk for intra-aortic balloon (IAB)-induced obstruction to the celiac axis (CA) or the renal artery (RA) when IAB size is chosen according to patient height and the tip is placed 2 cm distal to the origin of the left subclavian artery (LSCA), the computed tomography images of 150 Asian adults were reviewed to identify the distance from the LSCA to the CA (LSCA-CA) and to the RA (LSCA-RA). The diameter of the aorta at the level of the T9 vertebra, CA, and RA was also measured. The length and caliber of the IAB was selected according to two manufacturer's recommendations (Datascope Corp and Tokai Medical Products). The Datascope IAB potentially blocked the CA in 84 % and the RA in 66 %, while the Tokai IAB obstructed the CA in 61 % and the RA in 10 % of cases. The caliber of the IAB overlying the orifice of the RA was longer than the diameter of the aorta in 5 cases (3.3 %) using the Datascope IAB, and in 1 case (0.7 %) using the Tokai IAB. When placing an IAB selected based on patient height, the IAB could obstruct the orifice of the CA and RA in the majority of Asian patients, especially a Datascope IAB.