Catastrophic visceral arterial embolization after intra-aortic balloon pump withdrawal:a case report of mechanical thrombus strippingOA

Intra-aortic balloon pump(IABP)counterpulsation remains one of the most accessible forms of temporary mechanical circulatory support for cardiogenic shock and high-risk coronary intervention.Its physiologic benefits,augmentation of diastolic coronary perfusion and reduction of afterload,make it a pragmatic bridge during periods of profound instability.Nonetheless,IABP therapy carries clinically meaningful complications,including access-site bleeding,limb ischemia,and less commonly visceral ischemia.Reported vascular complication rates vary widely across contemporary series,ranging from 0.94% to 31.1%,[1]reflecting differences in patient risk profiles,device size,anticoagulation practices,and monitoring strategies.In routine practice,clinicians often navigate a narrow therapeutic margin:preventing thromboembolism while minimizing bleeding,particularly in elderly patients with shock physiology and diffuse atherosclerosis.