Left subclavian artery approach for insertion of IABP

: A 62-year-old man admitted with a complication of chest pain. Cardiac catheterization showed three vessel disease with ventricular dysfunction (EF 40%). And aortagram showed that he had arteriosclerosis obliterans (ASO). While he was waiting for operation, the frequency of chest pain increased. It was considered necessary for him to have IABP catheter inserted. We chose left subclavian artery as an access for the insertion of IABP catheter. The catheter was easily introduced into the descending aorta under the fluoroscopy. Emergency CABG was performed the day after insertion of IABP catheter. IABP removed the next morning of operation. Operation and postoperation course was uneventful. In this case, the insertion and the removal were possible under local anesthesia. Left subclavian approach was useful for emergency case with ASO.