Intra-Aortic Balloon Pump: Current Clinical Applications

Abstract

The intra-aortic balloon pump (IABP) remains one of the most widely used mechanical circulatory support devices in acute and chronic cardiac conditions such as cardiogenic shock, acute myocardial infarction, decompensated heart failure, and high-risk cardiac interventions. This review summarizes the principles of counter pulsation, physiological effects, key indications, patient-selection factors, complications, and recent technological advancements. IABP inflates during diastole to enhance coronary perfusion and deflates before systole to reduce afterload, thereby improving the myocardial oxygen supply–demand balance. Although newer support systems (Impella, ECMO) are increasingly used, IABP continues to offer practical, accessible, and cost-effective hemodynamic support, especially in resource-limited settings. Its role spans temporary stabilization, perioperative assistance, and bridging to definitive therapies such as cardiac surgery or transplantation. Recent innovations, including catheter miniaturization and improved insertion techniques, have enhanced device safety and performance. The combination of IABP with other mechanical assist devices may also provide synergistic benefits in selected patients. Overall, IABP remains a clinically relevant and evidence-based support option that continues to hold value in modern cardiac critical care