Published in:
01-08-2018 | Original Paper
Indication and short-term clinical outcomes of high-risk percutaneous coronary intervention with microaxial Impella® pump: results from the German Impella® registry
Published in: Clinical Research in Cardiology | Issue 8/2018
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Background
Percutaneous coronary intervention (PCI) is an alternative strategy to coronary artery bypass grafting (CABG) in patients with high perioperative risk. The microaxial Impella® pump (Abiomed, Danvers, MA, USA), used as prophylactic and temporary support, is currently the most common device for “protected high-risk PCI” to ensure hemodynamic stability during complex coronary intervention.
Methods
The study is an observational, retrospective multi-center registry. Patients from nine tertiary hospitals in Germany, who have undergone protected high-risk PCI, are included in the present study.
Results
A total of 154 patients (mean age 72.6–10.8 years, 75.3% male) were enrolled. The majority were at a high operative risk illustrated by a logistic EuroSCORE of 14.7–17.4. The initial SYNTAX score was 32.0–13.3, indicating very complex CAD and could be reduced to 14.1–14.3 (p < 0.0001) after PCI. The main reasons for protected PCI were complex coronary anatomy (70.8%), personal impression (56.5%), reduced ventricular ejection fraction (49.4%), comorbidities (47.4%), and surgical turndown (30.5%). Four patients (2.6%) experienced an intrahospital death.
Conclusions
Data from the study show that protected PCI is a safe and effective approach to revascularize high-risk patients with complex coronary anatomy and comorbidities.