Caldas JR, Panerai RB, Bor-Seng-Shu E, et al. - By performing this prospectively planned study of the earlier published IABCS (‘Intra-aortic Balloon Counterpulsation in Patients Undergoing Cardiac Surgery’) trial, researchers investigated how cerebral hemodynamics and neurological complications in patients undergoing cardiac surgery could be affected by the preoperative use of intra-aortic balloon pump (IABP). These patients were examined in the IABCS trial and were randomized to receive or not receive preoperative IABP. Preoperative IABP (n = 90) or no IABP (n = 91) was received by patients undergoing elective coronary artery bypass surgery with ventricular ejection fraction ≤ 40% or EuroSCORE (European System for Cardiac Operative Risk Evaluation) ≥ 6. Prior to the operation (T1) and 24 h (T2) and 7 days post-surgery (T3), they recorded cerebral blood flow velocity of the middle cerebral artery by means of transcranial Doppler and blood pressure via Finometer or intra-arterial line in patients with preoperative IABP (n = 34) and without IABP (n = 33). Findings revealed that cerebral hemodynamics remained unaffected by the preoperative use of the IABP in high-risk patients undergoing cardiac surgery. No link was identified between the preoperative use of the IABP and a higher incidence of neurological complications in these patients.