Background: The intra-aortic balloon pump (IABP) remains a commonly used temporary mechanical circulatory support device because it is relatively easy to implant, less invasive, and well established in clinical practice. Previous studies have focused primarily on the physiological mechanisms, indications, clinical outcomes, and complications of IABP, whereas its technological evolution and industrial research have not been systematically examined. Objective: This study aimed to characterize the global technological and industrial evolution of IABP; identify current research priorities and underdeveloped areas; and relate patent innovation to unresolved needs in hemodynamic support, vascular safety, counterpulsation accuracy, prolonged bridging, and patient transport. Methods: Patent documents related to IABP were retrieved from the PatSnap database using a combined search strategy based on keywords and International Patent Classification (IPC) codes. The search was limited to documents published by August 18, 2026. After screening and deduplication, simple patent families were used as the unit of analysis. Patentometric analysis and technology function matrix analysis were performed to characterize the technological evolution, geographical distribution, and major innovation directions of IABP technology. Results: A total of 1235 IABP-related patent families were identified. The United States, China, Japan, and Europe were the principal countries or regions of origin, together accounting for 89.1% (1100/1235) of the included simple patent families. China contributed 326 simple patent families, representing 26.4% of the global total, and showed particularly rapid growth over the past 5 years. IABP technology evolved through an embryonic stage (1968-1985), a steady development stage (1986-2012), and a rapid development stage beginning in 2013. Patent families were mainly classified as balloon components (n=552, 44.7%), catheters and accessories (n=416, 33.7%), and counterpulsation timing and control (n=161, 13%). The technology function matrix indicated that structural optimization and control precision are the current priorities in research and development, while balloon folding and compression, fiber-optic pressure sensing, and adaptive control algorithms have emerged as important hotspots. Conclusions: IABP innovation has focused on balloon catheter design, pressure sensing, and adaptive control to improve hemodynamic support and counterpulsation accuracy. However, safety and complication reduction remain underdeveloped, particularly for prolonged support and transport. Future systems should integrate durable, low-profile designs with sensing, adaptive timing, and failure monitoring and be evaluated in specific patient populations and clinical settings.

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