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Malpositioned Intra-Aortic Balloon Pump

Imaging findings

Chest radiograph and CT show an intra-aortic balloon pump (IABP) catheter traversing the descending aorta and looping abnormally back into the ascending aorta, causing incorrect positioning of the pump balloon.

Key takeaways

Surveillance of IABP catheters is essential. The radiopaque tip should reside in the descending thoracic aorta immediately distal to the origin of the left subclavian artery. Buckling or looping into the ascending aorta can cause mechanical malfunction, thrombosis, or aortic wall injury.

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