PMID- 36001456
OWN - NLM
STAT- MEDLINE
DCOM- 20220913
LR  - 20221118
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 34
IP  - 9
DP  - 2022 Sep
TI  - Complex High-Risk Indicated Percutaneous Coronary Intervention With Prophylactic 
      Use of the Impella CP Ventricular Assist Device.
PG  - E665-E671
LID - JIC20220819-1 [pii]
AB  - OBJECTIVES: Patients with complex coronary artery disease, concomitant cardiac 
      disease, and multiple comorbidities are addressed as complex higher-risk 
      indicated patients (CHIPs). Selecting a revascularization strategy in this 
      population remains challenging. If coronary artery bypass grafting is deemed high 
      risk or patients are considered inoperable, high-risk percutaneous coronary 
      intervention (PCI) with the support of the Impella CP ventricular assist device 
      (Abiomed) may be an attractive alternative. METHODS: In this retrospective, 
      multicenter study, we included consecutive patients undergoing Impella 
      CP-facilitated complex high-risk PCI. All patients were discussed by the heart 
      team and were declined for surgery. Additionally, periprocedural mechanical 
      circulatory support was deemed necessary. We collected demographic, clinical, and 
      procedural characteristics. Major adverse cardiac event (MACE) and mortality 
      rates up to 30 days were evaluated. RESULTS: A total of 27 patients (median age, 
      73 +/- 9.7 years; 74.1% men) were included in our study. The median SYNTAX score 
      was 32 (range, 8-57) and EuroSCORE was 7.25% (range, 1.33-49.66; +/- 12.76%). 
      Periprocedural hemodynamic instability was observed in 1 patient (3.7%). 
      In-hospital combined with 30-day mortality was 7.4% (2/27). No repeat 
      revascularization was necessary. MACE was observed in 10 patients (37.0%). Six 
      patients (22.2%) had a major bleeding complication, of which 2 were related to 
      Impella access site. Median Impella run time was 1.22 hours and there was no 
      significant decrease in kidney function. Median admission time after PCI was 3 
      days (range, 1-23; +/- 4.76). CONCLUSIONS: The Impella CP system showed good 
      feasibility and provided adequate hemodynamic support during high-risk PCI in 
      this CHIP population.
FAU - van den Buijs, Deborah M F
AU  - van den Buijs DMF
FAU - van den Brink, Floris S
AU  - van den Brink FS
AD  - Leids Universitair Medisch Centrum, Leiden, Zuid-Holland, 2333ZA, The 
      Netherlands. floris.s.van.den.brink@gmail.com.
FAU - Wilgenhof, Adriaan
AU  - Wilgenhof A
FAU - Zivelonghi, Carlo
AU  - Zivelonghi C
FAU - Verouden, Niels
AU  - Verouden N
FAU - Knaapen, Paul
AU  - Knaapen P
FAU - Sjauw, Krischan D
AU  - Sjauw KD
FAU - Vermeersch, Paul
AU  - Vermeersch P
FAU - Nap, Alex
AU  - Nap A
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220819
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Bypass
MH  - *Coronary Artery Disease/complications/diagnosis/surgery
MH  - Female
MH  - *Heart-Assist Devices
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - complex high-risk PCI
OT  - Impella CP
OT  - high-risk PCI
EDAT- 2022/08/25 06:00
MHDA- 2022/09/14 06:00
CRDT- 2022/08/24 12:33
PHST- 2022/08/25 06:00 [pubmed]
PHST- 2022/09/14 06:00 [medline]
PHST- 2022/08/24 12:33 [entrez]
AID - JIC20220819-1 [pii]
PST - ppublish
SO  - J Invasive Cardiol. 2022 Sep;34(9):E665-E671. Epub 2022 Aug 19.