Impella-protected PCI: the clinical results achieved so far.

Impella-protected PCI: the clinical results achieved so far. Minerva Cardioangiol. 2018 Apr 11;: Authors: Pesarini G, Gratta A, Dolci G, Lunardi M, Ribichini FL Abstract The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to the interventional toolbox. Up to date only few (4) randomized clinical trials (RCT) have tried to address the clinical efficacy of Impella assistance for the treatment of this very high- risk population, but several large registries and multiple observational studies have demonstrated its safety, feasibility and haemodynamic performance. Although the largest RCT (PROTECT II) have been prematurely stopped due to the risk of futility despite the evidence of more complete revascularization in the Impella arm, the need for an adequate operator's learning curve must be considered. More recent insights suggest an effect of the device in optimizing end-organ perfusion and improving crucial parameters like renal function. Furthermore, available d...
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research