The contribute of Impella during high-risk unprotected left main PCI

A new study confirms the positive support of Abiomed Impella ventricular assist devices during percutaneous coronary intervention (PCI). According to the study of Schreiber T et al. (Catheter Cardiovasc Interv. 2017;90(4):576-581 – link to the study), the use of prophylactic Impella® device support during unprotected left main (ULM) percutaneous coronary intervention (PCI) is safe and effective for improving hemodynamic variables in high-risk, non-cardiogenic shock (CS) patients.

Although coronary artery bypass grafting (CABG) surgery is considered the “gold standard” approach to anatomically challenging left main lesions, PCI in conjunction with additional mechanical and medical support is becoming adopted for high-risk and surgically ineligible patients. That choice arises from the fact that the prophylactic mechanical hemodynamic support during revascularization reduces myocardial ischemia and minimizes hemodynamic collapse. This study has involved over 100 patiens who received Impella device support during ULM PCI: the results showed that the endpoint of in-hospital mortality was 1.57% and 30-day mortality was 2.36%: this last result was approximately 50% less than that would have been predicted with CABG (STS-Society for Thoracic Surgery score: 2.36% vs 4%, respectively).

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