Intra-aortic Balloon Pump Catheter Research Articles

Perfusionist removal of intra-aortic balloon pump catheters improves efficiency without an increase in complication rates.

The intra-aortic balloon pump (IABP) is one of the most utilized cardiac assist devices. Patients receiving IABP therapy are typically managed in high acuity clinical care areas with limited bed space and high demand. Our center instituted a certified clinical perfusionist (CCP) led initiative to remove IABP catheters in order to reduce IABP therapy time, hasten removal and improve efficiency. The purpose of the study is to compare outcomes for IABP removal by a certified clinical perfusionist to a physician. The primary outcome measures were site hematoma score and limb related complications. A survey was submitted to bedside nurses, managers/patient care coordinators, CCP's and physicians. The IABP quality assurance database was interrogated for the study. There were 350 patients eligible for inclusion. The cohort was well balanced between CCP (n = 284) and physician (n = 66) groups for patient demographics, indication, insertion specifics and type of medical intervention. The majority of patients had no bruise or hematoma with perfusionist (n = 246, 87%) or physician (n = 58, 88%) (p = 0.78) removal. The physician group demonstrated a higher rate of grade 3 hematomas (p = 0.03). There was no statistically significant difference between CCP and physician groups for limb complications and mortality. Survey results showed an improved efficiency in bed space allocation, physician workload and a decreased IABP support time. There is no difference in limb complications between perfusionist and physician removal of IABP catheters. The survey demonstrate an improvement in resource allocation and efficiency. A perfusionist led IABP removal program can be done safely and may help improve program efficiency.

Intra-aortic Balloon Pump Securement.

Intra-aortic Balloon Pump Securement.

Safety of Bedside Portable Low-Field Brain MRI in ECMO Patients Supported on Intra-Aortic Balloon Pump.

(1) Background: Fifty percent of patients supported on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are concurrently supported with an intra-aortic balloon pump (IABP). Acute brain injury (ABI) is a devastating complication related to ECMO and IABP use. The standard of care for ABI diagnosis requires transport to a head CT (HCT) scanner. Recent data suggest that point-of-care (POC) magnetic resonance imaging (MRI) is safe and may be effective in diagnosing ABI in ECMO patients; however, no data exist in patients supported on ECMO with an IABP. We report pre-clinical safety data and a case series to evaluate the safety and feasibility of POC brain MRI in ECMO patients supported with IABP. (2) Methods: Prior to patient use, ex vivo testing with an IABP catheter within the Swoop® Portable MRI (0.064 T) System™ was conducted. After IRB approval, clinical testing was performed for the safety and feasibility of early ABI detection. (3) Results: No deflection force was measured with a 7.5 French Maquet Linear IABP within the 0.064 T field. Three adult ECMO patients (average age: 40 years; 67% female) supported with IABP completed four POC brain MRI exams (median exam time: 30 min). Multiple signal abnormalities were detected on the POC brain MRI, corresponding to HCT results. (4) Conclusions: Our preliminary results suggest that adult VA-ECMO patients with IABP support can be safely imaged with low-field POC brain MRI in the intensive care unit, allowing for the early and bedside imaging of patients.

Radiology of Intra-Aortic Balloon Pump Catheters.

Radiographs play an important role in ascertaining appropriate placement of the intra-aortic balloon pump catheter. This imaging essay highlights correct and incorrect positioning of these catheters, with emphasis on the variability of radiopaque markers used with different catheter models and on axillary versus femoral catheter placement routes. Keywords: Conventional Radiography, CT, Percutaneous, Cardiac, Vascular, Aorta, Anatomy, Cardiac Assist Devices, Catheters © RSNA, 2022.

Combined association of liver and renal injury by intra-aortic balloon pump malposition.

BACKGROUNDWe report an unusual visceral complication of intra-aortic balloon pump (IABP) due to the malpositioning of the catheter in the aorta.CASE REPORTA 55-year-old man with severe left ventricular dysfunction underwent coronary artery bypass grafting (CABG) with the preoperative use of an intra-aortic balloon pump. Postoperative course was complicated by renal and hepatic failure. The early occurrence of complications during 36 hours after operation exhibited a serious vascular complication. The combination of acute renal and hepatic failure led to the suspension to occlusive effect of intra-aortic balloon pump catheter on ostium of the aforementioned organs. The intra-aortic balloon pump was removed, and urine output immediately restored. Thereafter, daily slop dawn serum levels of aminotransferases were started, and became normal at the 10th day of operation.CONCLUSIONThis is an exceptional case that shows how intra-aortic balloon pump may be contributed to mechanical aortic side branches obstruction. A high index of suspension is mandatory in the diagnosis of such bizarre complications.

The Axillary Intra-Aortic Balloon Pump as a Bridge to Recovery Allows Early Ambulation in Long-Term Use: Case Series and Literature Review.

We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta. Three patients were transferred from outside facilities, requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure. Patients included a 54-year-old woman with occluded grafts and left ventricular thrombus after coronary artery bypass grafting, ejection fraction (EF) of 23.4% on dobutamine infusion, intra-aortic balloon pump support for 39 days, max daily ambulated distance of 1250 feet, and discharged home on day 51 on milrinone infusion; a 63-year-old man with kinked left internal mammary artery to left anterior descending artery graft (surgically repaired), multiple failed extubations requiring tracheostomy, EF of 15% on epinephrine and milrinone, intra-aortic balloon pump support for 43 days, max daily ambulated distance of 400 feet, and discharged home on day 54; and a 66-year-old man after redo coronary artery bypass grafting + carotid endarterectomy, with failure to wean off cardiopulmonary bypass requiring veno-arterial extracorporeal membrane oxygenator, EF of 20% on epinephrine and norepinephrine, intra-aortic balloon pump support for 41 days, max daily ambulated distance of 2800 feet, and discharged home on day 91. There were no infection, thromboembolic, cerebrovascular, bleeding, or intra-aortic balloon pump malpositioning/migration complications. We found that transaxillary artery intra-aortic balloon pump is well tolerated by patients and allows early ambulation and aggressive physical therapy in patients needing extended support. Duration of intra-aortic balloon pump support was up to 43 days with no complications.

Differential responses to larger volume intra-aortic balloon counterpulsation: Hemodynamic and clinical outcomes.

ObjectivesExamine hemodynamic and clinical correlates of use of an intra‐aortic balloon pump catheter in a single center.BackgroundThe intra‐aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes.MethodsAll patients who received IABC with a 50cc balloon for at least 1 hour were included in this retrospective chart review study. Demographics, comorbidities, lab values, and hemodynamic parameters were recorded at baseline and 15 h postinsertion.ResultsSeventy‐six patients had paired measurements of cardiac output. 60 patients had a higher cardiac output with IABC treatment (responder group) and 16 did not (nonresponders). In the 60 patients in the responder group, cardiac output and index significantly increased from baseline 3.6 ± 1.3 L/min to 5.2 ± 1.8 L/min, and 1.8 ± 0.5 L/min/m2 to 2.6 ± 0.8 L/min/m2 respectively following IABC placement (P < 0.0001 for both comparisons). Various hemodynamic variables were examined and the best predictor of response to IABC was a cardiac power index of 0.3 or less. Regardless of response, in hospital survival was similar between groups.ConclusionsThe majority of patients improve their cardiac output with IABC but survival was unchanged. Further work into the pathophysiology of cardiogenic shock is needed.

Physician-nurse cooperative behavior of emotion management in patients with IABP

Objective To explore an effective emotion management method for patients treated with intra-aortic balloon pump (IABP), in order to improve treatment compliance. Methods We recruited the patients who performed IABP from January 2013 to July 2014. All patients were conducted the physician-nurse cooperative behavior of emotion management (physician-nurse co-participation mode, codetermination of emotion management, establishment of procedure management flow, detection of hidden danger etc). We Compared and evaluated the results of pre and post intervention of emotion management strategies in IABP patients. Results After implementing physician-nurse cooperative methods, the scores [before the implementation, doctors (19.80±3.68) points, nurse (19.20±3.79) points, after the implementation of doctors (25.83±1.85) points, nurse (25.78±2.15) points] of physician-nurse collaboration increased significantly(P<0.05); the incidence of adverse events related to IABP treatment was below before implementation: catheter migration rate dropped from 4.48% to 1.06%; the occurrence of excessive sedation rate decreased 5.76% to 3.04%; IABP catheter unplanned extubation rate declined from 0.03% to 0 (P<0.05). Conclusions The application of physician-nurse cooperative behavior of emotion management can effectively improve the therapy of IABP. That plays an important role in IABP treatment, deserves the clinical expansion. Key words: Cooperation behavior of physician-nurse; Intra-aortic balloon pump; Emotion management

A New 35-mm Short Intra-aortic Balloon Catheter: A Suitable Option Also for Non-Small-Sized Patients?

Visceral ischemia can be a potentially life-threatening complication of intra-aortic balloon pump (IABP) support. A shorter IABP catheter might lead to a reduction of visceral complications. In this animal study, we evaluate the effects of a 35-mL short catheter in comparison with a 40-mL standard-sized catheter. Eighteen healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion being supported by either a short IABP catheter (short group) (n = 6) or a long IABP catheter (long group) (n = 6) or with no assistance (controls) (n = 6). Hemodynamics, visceral and coronary flows, as well as biochemical markers were evaluated throughout the different phases of the protocol. Mesenteric flows increased significantly at reperfusion (P < 0.001 both) remaining constant afterward (all, P > 0.05) in the short group, while remaining significantly lower in the long group at the start of reperfusion, remaining constantly lower than the short group and controls (P < 0.001 vs short, P < 0.003 vs controls). In both long and short groups, catheters improved renal flows at reperfusion (P < 0.001 both) without any further variation (P > 0.05). In the short group, the flows were higher during the whole of reperfusion (all, P < 0.05). Intra-aortic balloon pump support improved hemodynamic indices and coronary blood flows during reperfusion to a similar extent in both the small and the long group (P > 0.05). The short IABP catheter proved to be as effective as the standard-sized catheter in supporting hemodynamics and coronary circulation. Furthermore, it even improves visceral flows in comparison with conventional IABP catheters.

0229: Intra-aortic balloon pump in children: single-centre experience and overview of practices

Intra-aortic balloon pump (IABP) is a commonly used method of temporary circulatory support in adults. Despite the availability of paediatric size balloons, the use of IABP in children is currently not widespread. To describe our practice of IABP in children and to review its indications. Single-centre retrospective study. We reviewed the medical records of all paediatric patients (<18 years) who were supported with IABP from April 2010 to April 2015. We compare our practice with those reported in Pubmed (37 articles). During this period 7 patients (6 boys) had a circulatory support with IABP. Mean age was 12.1 years (10-14) and mean weight was 46.1kg (30-61). All were mechanically ventilated and received inotropic support at the time of IABP deployment. 2 IABP were started before surgery to treat acute heart failure (1 myocarditis and 1 ischemic condition). The major indication for IABP was postoperative hemodynamic deterioration (n=5). 4 of them were related to suboptimal cardioplegia in a context of left ventricular hypertrophy. Mean duration of IABP support was 7.1 days (2-13). All IABP catheters were inserted through the common femoral artery. No local complication was reported. All IABP were inserted by an intensivist without surgical help. IABP is a feasible method in children with acute left ventricular failure. By improving diastolic perfusion of the coronary arteries, IABP is effective especially in case of myocardial ischemia. This life-saving technique has to be associated to conventional medical treatment of refractory low cardiac output. Sometimes, IABP may be an alternative for effective mechanical circulatory support.

Intra-Aortic Balloon Pump Malposition Reduces Visceral Artery Perfusion in an Acute Animal Model.

Visceral artery perfusion can be potentially affected by intra-aortic balloon pump (IABP) catheters. We utilized an animal model to quantify the acute impact of a low balloon position on mesenteric artery perfusion. In six pigs (78 ± 7 kg), a 30-cc IABP was placed in the descending aorta in a transfemoral procedure. The celiac artery (CA) and the cranial mesenteric artery (CMA) were surgically dissected. Transit time blood flow was measured for (i) baseline, (ii) 1:1 augmentation with the balloon proximal to the visceral arteries, and (iii) 1:1 augmentation with the balloon covering the visceral arteries. Blood flow in the CMA and CA was reduced by 17 and 24%, respectively, when the balloon compromised visceral arteries compared with a position above the visceral arteries (flow in mL/min: CMA: (i) 1281 ± 512, (ii) 1389 ± 287, (iii) 1064 ± 276, P < 0.05 for 3 vs. 1 and 3 vs. 2; CA: (i) 885 ± 370, (ii) 819 ± 297, (iii) 673 ± 315; P < 0.05 for 3 vs. 1). The covering of visceral arteries by an IABP balloon causes a significant reduction of visceral artery perfusion; thus, the positioning of this device during implantation is critical for obtaining a satisfactory outcome.

Virtual 5-French intra-aortic pumping using a Glidesheath Slender and 6-French intra-aortic balloon catheter.

The aim of this study was to evaluate the feasibility and safety of the 6-Fr Glidesheath Slender, which has equivalent outer size to the conventional 5-Fr sheath, for use with the 6-Fr intra-aortic balloon pump (IABP) catheter. Between May 2014 and March 2015, 24 patients with acute coronary syndrome underwent percutaneous coronary intervention using a 6-Fr IABP catheter through a 6-Fr Glidesheath Slender for support. The adverse events, including access site complications, kinking of the sheath during the procedure, and any evidence of balloon pump failure, were retrospectively investigated. Insertion of the IABP catheter through either the femoral or brachial artery was successful in all patients. The mean support time was 32.4±22.0h. No major hemorrhagic event or severe limb ischemia was observed. Kinking of the shaft occurred during insertion in one patient; however, the subsequent balloon pumping was well maintained and did not require exchange of the sheath or IABP catheter. No kind of IABP failure was observed. Although this sheath was originally designed to allow radial access, our results suggest that the use of the Glidesheath Slender is feasible for insertion of the 6-Fr IABP catheter through the brachial and femoral arteries, and may reduce vascular complications in patients who undergo percutaneous coronary intervention.

Rapid Switch from Intra-Aortic Balloon Pumping to Percutaneous Cardiopulmonary Support Using Perclose ProGlide.

We present a case of a patient who needed rapid switch from intra-aortic balloon pumping (IABP) to percutaneous cardiopulmonary support (PCPS)/venoarterial extracorporeal membrane oxygenation. It is difficult to switch from IABP to PCPS, because 0.035-inch guidewires cannot pass the IABP guidewire lumen (0.025-inch compatible), and the IABP sheath needs to be removed together with the IABP catheter. First, a 0.025-inch guidewire was inserted into the IABP wire lumen, and then the IABP catheter together with the 8 Fr IABP sheath was removed, leaving the 0.025-inch guidewire in place. We used the Perclose ProGlide for safe and rapid exchange of the 0.025-inch guidewire for a 0.035-inch guidewire. This allowed insertion of a PCPS cannula and the prompt initiation of PCPS.

Intraaortic Counterpulsation During Cardiopulmonary Bypass Impairs Distal Organ Perfusion

Recent studies have focused on the use of fixed-rate intraaortic balloon pumping (IABP) during cardiopulmonary bypass (CPB) to achieve pulsatile flow. Because application of an IABP catheter may represent a functional obstruction within the descending aorta, we explored the effect of IABP-pulsed CPB-perfusion with special attention to perfusion above and below the IABP balloon. Sixteen animals received an IABP catheter that remained turned off position (NP group, n = 8) or was switched to an automatic mode of 80 beats/min during CPB (PP group, n = 8). Flow-data and pressure-data were obtained above and below the IABP balloon. Tissue perfusion was evaluated by microspheres. IABP-pulsed CPB-perfusion, as assessed at 30 minutes on CPB, increased proximal mean aortic pressure (p < 0.05) and carotid artery blood flow (p < 0.001), but decreased distal mean aortic pressure (p < 0.001). The decrease of distal mean aortic pressure in the PP group was associated with a 75 % decrease (p < 0.001) of renal tissue perfusion. During nonpulsed perfusion the respective variables remained essentially unchanged compared with pre-CPB levels. Using IABP as a surrogate to achieve pulsatile perfusion during CPB contributes significantly to lowered aortic pressure in the distal portion of aorta and impaired tissue perfusion of the kidneys. The results are focusing on effects that may contribute to organ dysfunction and acute kidney injury. Consequently, assessment of perfusion pressure distal to the balloon should be addressed whenever IABP is used during CPB.

What you would not expect after a difficult intra-aortic balloon pump removal

Figure 1: Intra-aortic balloon pump catheter after removal, showing an intact balloon envelope but a broken internal wire (arrow). The balloon was inserted prophylactically with an uncomplicated sheetless technique at the time of operation in the anaesthetic room. The patient was extubated on postoperative day 1 and the balloon had to be removed the following morning (i.e. 48 h after its insertion).

Transaortic Intra-Aortic Balloon Pump Catheter Insertion through a Separate Saphenous Vein Graft in Patients with Severe Aortoiliac Disease

Background. Intra-aortic balloon pump (IABP) is the most widely used mechanical assist device for hemodynamic support in high risk patients undergoing cardiac surgery. The aim of our study was to confirm whether transaortic route is a suitable alternative to allow IABP insertion in patients with severe aortoiliac diseases. Methods. This study included 7 consecutive patients undergoing coronary artery bypass grafting for severe coronary artery disease associated with severe aortoiliac disease. These patients could not be weaned from cardiopulmonary bypass and required the IABP support, which were placed through the ascending aorta. IABP catheter was inserted indirectly through a separate saphenous vein graft anastomosed to the ascending aorta by an end-to-side manner under a partial occluding clamp and advanced to the desired position in the descending thoracic aorta and exteriorly brought into the subcutaneous tissues in the jugulum. Results. The procedure was successfully performed in all the patients. The mean duration of IABP support was 54.0 ± 13.4 hours. There were no in-hospital mortality and complications related to transaortic route. IABP removal did not require repeat sternotomy. At postoperative 6th month, multislice CT examination showed thrombotic occlusion at the remnant of the saphenous vein graft. Conclusions. This technique is a simple, reliable, and reproducible option in patients with severe aortoiliac disease in whom retrograde femoral route is not possible.

Use of Novel 6 French Intra-Aortic Balloon Pump Catheter for Patients Undergoing Percutaneous Coronary Intervention

This study aimed to evaluate the feasibility and safety of a new 6 French (6 Fr) intra-aortic balloon pumping (IABP) catheter for patients undergoing percutaneous coronary intervention (PCI). Sixty-nine consecutive patients who received a 6 Fr IABP catheter were retrospectively evaluated. Patients with height <162 cm were primary selected for the 6 Fr IABP catheter treatment because of limited balloon size (30 ml). These catheters were also used for patients for whom the femoral approach was contraindicated. The mean age of the patients was 76.9 years. The average height and body weight were 156.7 cm and 56.0 kg, respectively. The 6 Fr IABP catheters were successfully inserted in all 69 patients, including four patients treated via the brachial artery. No patient developed limb ischemia. Poor helium inflation due to kinking of the catheter shaft occurred in one patient and helium leakage in one patient. The other 67 patients were well supported, and no patient required the 6 Fr catheter to be exchanged with a larger balloon catheter. The current study demonstrates that using this novel and currently, the thinnest IABP catheter is feasible and safe for small-sized patients undergoing PCI and seems promising for reduction in vascular complications. Brachial insertion is also possible using the 6 Fr IABP catheter; this may solve access site limitations observed with existing conventional IABP catheters.

A successful percutaneous removal of a ruptured and detached intra-aortic balloon pump with vascular entrapment

Introduction: Intra-aortic balloon pump (IABP) rupture and entrapment is a rare complication which may necessitate major surgery. Case report description: A 74 years old man was admitted to our hospital for coronary angiography (CA) after successfull rescucitation. The CA revealed a 95% left main stenosis with an occluded first obtuse marginal branch and an occluded right coronary artery. Emergent coronary artery bypass grafting was performed. The patient remained stable under the support of IABP (7Fr 40cc RediGuard IAB, Arrow International Inc. USA) until the fourth post-operative day, when a dysfunction of the IABP was noted. After several attempts to remove IABP at the patient's bedside, urgent fluoroscopy performed and showed the detached tip of intra-aortic balloon at the proximal third of the right common iliac artery (RCIA) and the IABP catheter shaft more distal. Left brachial artery (LBA) aortography revealed total occlusion of the RCIA. A pediatric balloon (8mm x 30mm Opta Pro Balloon,Cordis, Miami, FL) was advanced through the LBA to the proximal level of the RCIA, which was dilated and thus, facilitated IABP removal. Although no arterial dissection or rupture was observed, occlussive thrombi were visualized through the RCIA. Despite multiple dilatations with the balloon, total occlusion of RFA was ultimately demonstrated. Surgical thrombectomy was then, performed to restore patency and blood flow. ![Figure][1] Figure 1. Procedure and findings of IABP removal Discussion: A plausible mechanism for balloon rupture and thrombosis is its compression against calcified atherosclerotic plaques. Attempted forceful extraction or IABP technical deffect may have contributed to the detachment of the balloon from IABP catheter shaft. Conclusion: Percutaneous interventions may resolve successfully vascular complications during IABP support. [1]: pending:yes

A Novel Technique for Intra-aortic Balloon Positioning in the Intensive Care Unit

Proper positioning of the intra-aortic balloon catheter is very important as an improperly placed balloon can cause problems. A balloon placed too high can block off the arch vessels, whereas one placed too low can block the renal and splanchnic vessels. We propose a simple and reliable technique to properly position the intra-aortic balloon pump (IABP) catheter without the use of any sophisticated or expensive equipment in the intensive care unit if the catheter has migrated from the previously placed desired position. In this technique, we rely on the left radial arterial trace obliteration as the IABP catheter is pushed in along a guidewire as a marker for tip positioning.

Certification Review

1.Which of the following is a “total artificial heart” device? A.JarvikB.HeartWareC.DeBakeyD.AbioCorAnswer: D. The AbioCor is a total artificial heart device. The other options are all left ventricular assist devices.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 467.2.Pump failure occurs during transport of a 56-year-old man with an intra-aortic balloon pump (IABP) in place. Which of the following interventions is appropriate? A.Stop the pump, clamp the catheter, and place the patient in the left lateral position.B.Stop the pump and inflate the IABP catheter once every 3–5 minutes manually with a 60-mL syringe.C.Begin cardiopulmonary resuscitation and place the IABP in the internal 80 default setting.D.Decrease the inflation volume in the catheter and place the pump on a 1:3 timing mode.Answer: B. If pump failure occurs during transport, stop the pump and inflate the IAB catheter every 3–5 minutes manually with a 60-mL syringe. For an IAB rupture, the team should stop the pump, clamp the catheter, and place the patient in the left lateral position. Begin CPR and place the IABP in the internal 80 default setting if the patient arrests.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 444.3.Which of the following IABP timing errors will result in retrograde coronary blood flow? A.Early inflationB.Late inflationC.Early deflationD.Late deflationAnswer: C. Early deflation will cause retrograde coronary blood flow. Early inflation results in premature closing of the aortic valve, causing aortic regurgitation. Late inflation results in suboptimal coronary perfusion. Late deflation increases resistance or afterload.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 442.4.How often during air medical transport should the flight crew manually autofill the IABP catheter? A.Every 2,000 ft of ascent and 1,000 ft of descentB.Every 1,000 ft of ascent and 2,000 ft of descentC.Every 1,000 ft of ascent and descentD.Every 2,000 ft of ascent and descentAnswer: A. When a manual autofill is required, the transport crew should perform it with every 2,000 feet of ascent and every 1,000 feet of descent. New generations of IABPs have sensors that detect altitude changes, and they will perform the autofill automatically.Holleran R, ed. Air and Surface Patient Transport: Principles and Practice. 4th ed. St. Louis: Mosby; 2010: 442.5.The goal of inflation during IABP catheterization is to produce a ____________, which optimizes diastolic augmentation. A.Rapid rise in systolic pressureB.Rapid rise in aortic pressureC.Rapid decrease in systolic pressureD.Rapid decrease in aortic pressureAnswer: B. The goal of inflation is to produce a rapid rise in aortic pressure to optimize diastolic pressure, thereby increasing oxygen supply to the coronaries.Holleran R, editor. Air and surface patient transport: Principles and practice. 4th ed. St. Louis: Mosby; 2010: 441.