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Intra-Aortic Balloon Pump Malposition

Imaging findings

Chest radiograph shows the balloon tip of an intra-aortic balloon pump (IABP) positioned too proximally, crossing the aortic arch and entering the ascending aorta, shown inflated during diastole.

Key takeaways

Proper positioning of the IABP tip is 1-2 cm distal to the origin of the left subclavian artery. Inappropriate proximal migration into the aortic arch or ascending aorta can lead to carotid or subclavian artery occlusion, cerebral thromboembolism, or aortic root dissection, requiring immediate repositioning.

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