The role of Impella in high-risk percutaneous coronary intervention

Abstract

Percutaneous coronary intervention (PCI) has been increasingly performed in patients with severely depressed left ventricular function and complex coronary lesions, including multivessel disease. Mechanical ventricular assist devices play an increasingly important role in high-risk PCI. Impella CP (Abiomed, Inc.) is a new percutaneous left ventricular assist device, designed for short-term circulatory support. It is a promising option for hemodynamic support in high-risk procedures and can potentially reduce PCI-related complications. The authors present two case reports of high-risk PCI using the Impella CP device. In the setting of low coronary flow reserve, severely depressed left ventricular function and potential hemodynamic instability, the Impella CP device has made it possible to maintain hemodynamic stability during procedures, without being associated with vascular complications.

DCM Support: cell therapy and circulatory support for dilated cardiomyopathy patients with severe ventricular impairment

“…The Impella device is currently used in clinical practice to facilitate high-risk coronary interventional procedures (especially in patients with severely impaired LV function or cardiogenic shock). [18][19][20][21] The device is known to reduce end-diastolic wall stress and pulmonary capillary wedge pressure, 18,22,23 therefore preventing acute decompensation.…”

The 10 Commandments of Microaxial Temporary Left Ventricular Assist Devices

“…Impella utilization has been extensively described in the setting of high-risk percutaneous coronary intervention (PCI) procedures. [6][7][8] In these cases, patients can be supported hemodynamically while the coronary arteries are accessed and stented. Impella support in this scenario is generally reserved for patients with a high risk of hemodynamic compromise during these procedures, including those with reduced LV ejection fraction and either multivessel coronary artery disease or left main disease.…”

Case report: Cytokine therapy and an intracoronary autologous bone marrow-derived cell infusion with Impella support in a patient with dilated cardiomyopathy and a severely reduced ejection fraction

“…The Impella CP device (Abiomed, Danvers, MA; Figure 1 ) is a percutaneous mechanical circulatory support device that can be used in clinical practice to facilitate high-risk coronary interventions (particularly in patients with severely impaired left ventricular function or cardiogenic shock) ( 15 – 17 ). It is known to reduce end-diastolic wall stress and pulmonary capillary wedge pressure ( 15 , 16 , 18 )—thereby preventing acute decompensation.…”