CTICasesMalpositioned IABP
Imaging findings
Chest radiograph demonstrates the radiopaque tip of an intra-aortic balloon pump (IABP) catheter positioned in the proximal left subclavian artery. The catheter was introduced retrograde from the left subclavian/axillary artery.
Key takeaways
Intra-aortic balloon pumps (IABP) can occasionally be placed via an upper extremity access (subclavian or axillary artery) for patients who cannot undergo femoral access. However, because advance of the catheter is directed inward (contrary to femoral pullback), advanced positioning must be carefully monitored to prevent the balloon from inflating in a small branch vessel (such as the subclavian artery), which carries a high risk of vascular tear, thrombosis, or limb ischemia.
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