Decreased incidence of arterial thrombosis using heparin-bonded intraaortic balloons

Background. This experimental study sought to determine whether heparin-bonding of intraaortic balloons (IAB) would decrease the incidence of arterial thrombosis in the absence of systemic heparinization. Methods. In 25 adult pigs, a 9F, 40-mL IAB was inserted into the femoral artery and positioned just below the takeoff of the left subclavian artery for 9 hours. Five animals received systemic heparin, 10 animals had no heparin, and another 10 animals received no heparin but the IAB was heparin-bonded (Duraflo II). Thrombus formation was assessed using a numerical scoring system (0 = no thrombosis to 3 = thrombus >5 cm or evidence of luminal compromise). Results. Animals receiving heparin and heparin-bonded IAB had no thrombus formation around the IAB (mean ± SE; 0 ± 0.00 heparin versus 1.55 ± 0.29 no heparin versus 0 ± 0.00 heparin-bonded; p < 0.005), at the insertion site (0 ± 0.00 heparin versus 1.55 ± 0.29 no heparin versus 0 ± 0.0 heparin-bonded; p < 0.005), and in the distal femoral artery (0 ± 0.00 heparin versus 2.00 ± 0.23 no heparin versus 0 ± 0.00 heparin-bonded; p < 0.005). Conclusions. Heparin-bonding of the IAB significantly decreases thrombus formation in the absence of systemic heparinization.