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Comparison of Heart Failure Cardiogenic Shock patients with Axillary and Femoral Intra-aortic Balloon Pump: A CSWG report
Journal article   Peer reviewed

Comparison of Heart Failure Cardiogenic Shock patients with Axillary and Femoral Intra-aortic Balloon Pump: A CSWG report

Arvind Bhimaraj, Arthur R. Garan, Qiuyue Kong, Ju Kim, Mohit Pahuja, Ajar Kochar, Smitha Narayangowda, Borui Li, Song Li, Shashank S. Sinha, …
Journal of cardiac failure
Aug 2025
DOI: https://doi.org/10.1016/j.cardfail.2025.07.020

Abstract

Axillary IABP Cardiogenic Shock Clinical Outcomes Femoral IABP
To describe the outcomes of patients receiving axillary (Ax) IABP and compare with those receiving Femoral (Fem) IABP for heart failure related cardiogenic shock (HF-CS). IABPs are traditionally placed via the femoral artery. Single center studies have shown the utility of axillary placement to promote ambulation. Utility of Ax IABP in CS has not been established. Data from the Cardiogenic Shock Working Group (CSWG), a multi-center academic consortium, was analyzed from 2020-2023. We examined demographic, metabolic, hemodynamic characteristics and outcomes of HF-CS patients treated with Ax-IABP and compared them to those who primarily received a Fem- IABP. Out of 6201 CS patients in the registry, 557 (8.9%) patients received an IABP for HF-CS, of whom 244 (43.8%) and 313 (56.2%) received Ax-IABP and Fem-IABP respectively. Compared to Fem-IABP, Ax-IABP patients were more likely to have prior intra-cardiac defibrillators (42.5% vs 68.9%, p<0.001). Time to IABP implant from admission (7.9±10.6 vs 1.8±6.1, p<0.01) and duration of support (9.6±14.6 vs 4.0±4.5, p<0.01) were longer among Ax-IABP, relative to Fem-IABP. Ax-IABP patients were more likely to undergo heart replacement therapy (65% vs 21%, p<0.001) compared to the Fem-IABP cohort. The rate of reported complications was similar between the two groups. Axillary IABP is being utilized beyond single center reports to support HF-CS mostly as a bridge to heart replacement therapies. Its use might provide advantages over fem-IABP. [Display omitted]

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