An IABP is placed either percutaneously or under surgical exposure into a large peripheral artery (most commonly femoral) and directed retrograde into the thoracic aorta over a wire. The optimal position is with the tip of the balloon positioned just distal to the origin of the left subclavian artery and the proximal end of the balloon before the orifice of the renal arteries. IABPs are positioned using fluoroscopy/x-radiography, or under the guidance of transesophageal echocardiography (TEE). Incorrect placement can obstruct the cerebral or visceral arteries, which can result in cerebral or visceral organ ischemia and ineffective counterpulsation. During IABP support, patients are usually anticoagulated.

References

• Baldetti L, Beneduce A, Boccellino A, et al. Bedside intra-aortic balloon pump insertion in cardiac intensive care unit: a single-center experience. Catheter Cardiovasc Interv. 2022;99:1976-1983.
• Rodriguez Lima DR, Duran EJ, Rojas Díaz EL, et al. Ultrasound-guided insertion of intra-aortic balloon counterpulsation in intensive care: description of the technique. Ultrasound J. 2020;12:23.