Real‐world use of the Impella 2.5 circulatory support system in complex high‐risk percutaneous coronary intervention: The USpella Registry

Catheterization and Cardiovascular Interventions - Tập 80 Số 5 - Trang 717-725 - 2012
Brijeshwar Maini1, Srihari S. Naidu2, Suresh Mulukutla3, Neal S. Kleiman4, Theodore Schreiber5, David Wohns6, Simon Dixon7, Charanjit S. Rihal8, Rajesh Davé9, William W. O’Neill10
1Pinnacle Health System, Harrisburg, Pennsylvania, USA.
2Winthrop University Hospital
3University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
4Methodist DeBakey Heart and Vascular Center, Houston, Texas
5Harper University Hospital
6 Spectrum Health
7William Beaumont University Hospital
8Mayo Clinic, Rochester, Minnesota
9Pinnacle Health System, Harrisburg, Pennsylvania
10University of Miami

Tóm tắt

AbstractObjectives: We report on the real‐world, multicenter experience of the Impella 2.5 circulatory support system during high‐risk PCI, a subset of the larger USpella Registry. Background: Standard of care for most patients with compromised ventricular function with multivessel or high‐risk coronary lesions has been coronary artery bypass grafting. In poor operative candidates, high‐risk PCI is increasingly considered, despite an increased risk for periprocedural hemodynamic compromise. Methods: 175 consecutive patients who underwent high‐risk PCI with prophylactic support of the Impella 2.5 were evaluated. The primary safety endpoint was the incidence of major adverse cardiac events (MACE) at 30 days. Secondary endpoints included safety and efficacy related to the device and patient outcomes, including survival at 12 months. Results: Overall angiographic revascularization was successful in 99% of patients and in 90% of those with multivessel revascularization, resulting in a reduction of the mean SYNTAX score post‐PCI from 36 ± 15 to 18 ± 15 (P < 0.0001) and an improvement of the ejection fraction (from 31 ± 15% to 36 ± 14%, P < 0.0001). In 51% of patients, the functional status improved by one or more NYHA class (P < 0.001). At 30‐day follow‐up, the rate of MACE was 8%, and survival was 96%, 91%, and 88% at 30 days, 6 months, and 12 months, respectively. Conclusions: The use of Impella 2.5 in high‐risk PCI appeared feasible and safe in the real‐world setting. The utilization of the Impella 2.5 was successful, resulting in favorable short‐ and midterm angiographic, procedural and clinical outcomes. © 2012 Wiley Periodicals, Inc.

Từ khóa


Tài liệu tham khảo

10.1016/j.jacc.2004.12.082

10.1161/CIRCULATIONAHA.107.752147

10.4244/EIJV3I4A81

10.1056/NEJMoa0801441

10.1056/NEJMoa0804626

10.1016/j.ahj.2006.02.024

10.1016/j.amjcard.2006.03.036

10.1016/j.amjcard.2005.10.037

10.2459/JCM.0b013e3282f9abe7

10.1016/j.jcin.2008.11.005

10.1016/j.jacc.2009.09.018

10.1002/ccd.20380

10.1002/ccd.21160

10.1002/ccd.22263

Sianos G, 2005, The SYNTAX score: An angiographic tool grading the complexity of coronary artery disease, EuroIntervention, 1, 219

10.1016/S0003-4975(03)00179-6

10.1016/j.carrev.2009.07.006

10.1002/(SICI)1097-0304(199810)45:2<115::AID-CCD3>3.0.CO;2-F

10.1016/j.euje.2004.03.008

10.1016/j.amjcard.2008.09.088

10.1016/0735-1097(90)90170-T

10.1016/S0002-9149(99)80379-8

10.1002/ccd.21072

10.1016/j.jcin.2010.01.011

10.1161/CIRCULATIONAHA.107.188208

Perera D, Elective intra‐aortic balloon counterpulsation during high‐risk percutaneous coronary intervention. A randomized controlled trial, JAMA, 2010, 867

Health research international 2009 report: US opportunities in acute cardiac assist technologies. Report #0514‐1‐US‐1209‐204‐ December2009.

10.1093/eurheartj/ehi161

Thông tin
Thông tin xuất bản

Catheterization and Cardiovascular Interventions

Tập 80 Số 5

717-725

Thông tin tác giả