CTICasesIatrogenic Aortic Injury from Intra-Aortic Balloon Pump (IABP)
[...]. Iatrogenic Aortic Injury from Intra-Aortic Balloon Pump (IABP). CTICases. Published August 13, 2021. https://str-case-explorer.pages.dev/c/aukbq
Imaging findings
Serial chest radiographs show progressive left para-aortic mediastinal widening, loss of the aortopulmonary window, and rightward deviation of the trachea following the placement of an intra-aortic balloon pump (IABP). A subsequent chest CT reveals a large mediastinal hematoma surrounding the descending thoracic aorta and a small focal aortic wall defect or dissection entry point.
Key takeaways
Aortic perforation or dissection is a rare and potentially catastrophic iatrogenic complication of intra-aortic balloon counterpulsation. It can occur during device placement or from mechanical wall trauma during balloon cycling. Rapid recognition of widening mediastinal contours on radiographs is critical, and treatment typically requires endovascular stent-graft repair.
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