Use of the Impella 2.5 for prophylactic circulatory support during elective high-risk percutaneous coronary intervention.

摘要: Abstract Background Patients undergoing percutaneous coronary intervention (PCI) who are at high risk for cardiovascular collapse during the procedure may benefit from prophylactic circulatory support. The objective was to evaluate safety and feasibility of use Impella 2.5 high-risk PCI. Methods materials We used partial support 60 consecutive elective PCI cases over 20 months. All patients either were deemed inoperable by cardiac surgeons or offered bypass surgery but declined. Results had multiple factors including hypertension (95%), diabetes (52%), chronic pulmonary disease (23%), prior myocardial infarction (62%) (18%). Forty-five percent presented with acute syndrome. mean left ventricular ejection fraction 23%±15%. Nearly all multivessel (93%), 60% main disease. average SYNTAX score 30±9. Despite lesion complexity factors, we achieved an angiographic success rate 96%. Left lesions treated in 55% patients, 83% treated. There one procedural death. At 30 days postintervention, mortality 5%, rates infarction, stroke, target vessel revascularization urgent 0%. Conclusions single-center experience reported here demonstrates that “real world” — outside controlled environment a clinical trial is safe feasible.