• A percutaneous intra-aortic balloon pump (PIABP) was inserted in 112 patients. Successful placement was achieved in 102 patients, 67 of whom survived long enough to have the device removed. Vascular complications related to the PIABP were noted in 15 patients. Reversal of ischemic signs followed PIABP removal in six patients, but nine required femoral artery exploration for thrombectomy, repair of femoral laceration, or repair of false aneurysm. No patient died as a result of PIABP or correction of associated vascular complications, though five of the patients with vascular problems died of cardiac complications. Nine of ten survivors in this group were asymptomatic, and one had persistent paresthesias six months postoperatively. Most clinically significant vascular complications were due to the technique of balloon removal, and several modifications that were effected recently are expected to decrease the incidence of complications requiring surgical intervention. (Arch Surg 1983;118:963-964)