CTICasesMalpositioned Intra-Aortic Balloon Pump Catheter
Imaging findings
Serial chest radiographs show an intra-aortic balloon pump (IABP) catheter inserted via an axillary artery approach. Over time, the catheter tip is seen migrating superiorly into the aortic arch and eventually into the brachiocephalic artery, where balloon inflation with helium is visible.
Key takeaways
The intra-aortic balloon pump (IABP) catheter tip should ideally reside in the proximal descending aorta, just distal to the left subclavian artery. Upper extremity approaches (axillary or subclavian) are prone to upward migration, which is dangerous as balloon inflation in the arch or brachiocephalic artery can cause vessel trauma, occlusion of the carotid arteries, and cerebral ischemia.
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