The initial experience with percutaneous axillary IABP implantation demonstrated that the technique is feasible, safe, and reproducible in patients hospitalized with advanced heart failure listed for heart transplantation, though further studies are needed to define its role.
Percutaneous axillary IABP implantation was successfully performed in all 22 patients selected for the axillary approach at a Brazilian advanced HF referral center.
The cohort consisted of middle-aged patients hospitalized with refractory heart failure who were all listed for heart transplantation.
Axillary IABP support was prolonged, with a median duration of 15 days.
Device migration and limb ischemia were the main complications observed, with isolated infectious and neurological events.
Half of the patients either underwent heart transplantation or were successfully weaned from mechanical support.
The authors concluded that percutaneous axillary IABP implantation is feasible, safe, and reproducible, motivated by the mobility limitation of femoral implantation.
This study describes the first experience at a major Brazilian heart failure center with placing an intra-aortic balloon pump, a device that helps a failing heart pump blood, through an artery near the shoulder (the axillary artery) instead of the groin. Placing the pump through the groin forces patients to stay in bed, so the axillary route is meant to allow more movement during support. Between December 2020 and December 2023, 22 hospitalized patients with severe heart failure who were waiting for a heart transplant received the pump this way. The procedure was successfully done in all of them, and the pump stayed in for a median of 15 days. Complications included the device moving out of position (about 18% of patients) and reduced blood flow to the limb (about 9%), along with a few isolated infections and neurological events. Half of the patients either received a heart transplant or were weaned off the device. This research suggests the shoulder-artery approach can be done safely and reliably at an experienced center. However, it was a small study at one hospital with no comparison group, so it cannot show whether this approach is better than the groin approach. Larger studies are needed to clarify where it fits in the care of patients waiting for a heart transplant.
Rocha B, Melo P, Mapa L, Oliveira R, Freire A, Mejía H, et al.. (2026). Percutaneous Axillary Intra-Aortic Balloon Pump Implantation in Patients Hospitalized with Heart Failure: Initial Brazilian Experience.. Arquivos brasileiros de cardiologia. https://doi.org/10.36660/abc.20250735