Total aortic occlusion caused by sustained balloon inflation: a previously unreported complication of intraaortic balloon counterpulsation.

A case of acute lower-body ischemia 2 days following intraaortic balloon pump insertion is reported. Fluoroscopy revealed persistent balloon inflation throughout the cardiac cycle with distal aortic occlusion. Attempts to manually deflate the balloon were unsuccessful until a guidewire was advanced through the gas-exchange lumen into the body of the balloon. The balloon catheter was removed without clinical sequelae other than transient oliguria and an asymptomatic increase in creatinine phosphokinase (CPK). This is a previously unreported complication of intraaortic balloon counterpulsation.