Intra-Aortic Balloon Pump Placement in the Axillary Artery: Where are We?

The prevalence of patients with heart failure (HF) in Brazil is high, with an increasing number of hospitalizations for advanced HF in tertiary care services. This suggests that patients’ conditions are persistently more severe, with recurrent episodes of pulmonary congestion or low cardiac output requiring frequent hospitalization. Multidisciplinary clinical support and optimized medical therapy are fundamental in the treatment of these patients. However, in refractory cases, bridge or destination therapies such as circulatory or ventricular assist devices (VADs) and heart transplantation may be indicated.^,

Patients with decompensated INTERMACS 2 or 1 HF may have an indication for mechanical circulatory support (MCS) during hospital stay. Devices currently available in Brazil include intra-aortic balloon pump (IABP), Impella CP, venoarterial extracorporeal membrane oxygenation, and Centrimag. The IABP is the most used device in Brazil and worldwide due to easy access, cost-effectiveness, and simple implant procedure and management. Despite having a modest effect on cardiac output, the IABP has a significant impact on circulatory hemodynamics, is simpler to use, and has an equal or superior safety profile compared with more modern devices.^–

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