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Rivista sulle Malattie del Cuore e dei Vasi

Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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Minerva Cardioangiologica 2018 Mar 08

DOI: 10.23736/S0026-4725.18.04656-X


lingua: Inglese

Percutaneous coronary intervention in patients refused from surgery: a different entity?

Rocco A. MONTONE, Giampaolo NICCOLI

Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy


Patients with left main or multivessel coronary artery disease (CAD) and depressed left ventricular function undergoing coronary artery by-pass grafting (CABG) have a markedly worse prognosis compared with general population, making surgical treatment of CAD unattractive especially when features such as poor distal targets, severe comorbidities, reoperation, advanced age, or impaired renal function are present. At the same time, evidence for improved clinical outcome in this high-risk subset of patients using mini-invasive surgical techniques (i.e. off-pump CABG or hybrid coronary revascularization) is still lacking (13). On the other hand, recent studies suggested that a revascularization strategy with a protected percutaneous coronary intervention (PCI) using a mechanical assistance device may be a viable alternative for these patients. In particular, the development of percutaneous left ventricular assist devices such as Impella has been an important step to facilitate the care of these high-risk patients. In this review we discuss about conditions for surgical ineligibility and the clinical outcome of PCI in high-risk patients ineligible for surgery. Moreover, we discuss about the evidences supporting the use of Impella in high-risk patients ineligible for surgery.

inizio pagina

Publication History

Article first published online: March 8, 2018
Manuscript accepted: March 5, 2018
Manuscript received: February 28, 2018

Per citare questo articolo

Montone RA, Niccoli G. Percutaneous coronary intervention in patients refused from surgery: a different entity?. Minerva Cardioangiol 2018 Mar 08. DOI: 10.23736/S0026-4725.18.04656-X

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