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MINERVA CARDIOANGIOLOGICA

Rivista sulle Malattie del Cuore e dei Vasi


Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2018 Apr 11

DOI: 10.23736/S0026-4725.18.04678-9

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Impella-protected PCI: the clinical results achieved so far

Gabriele PESARINI, Andrea GRATTA, Giulia DOLCI, Mattia LUNARDI, Flavio L. RIBICHINI

Division of Cardiology, University of Verona, Verona, Italy


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The ability of interventional cardiologists to identify high-risk percutaneous coronary interventions (PCI) patients, requires the integration of different features belonging to medical history, organ damage, coronary anatomy and the nature of the acute event. The selection of a subgroup of patients that could benefit from mechanical support during interventions is a key feature to success. The introduction of the Impella percutaneous axial pump have added an easy to set-up, less-invasive and time consuming active-support device to the interventional toolbox. Up to date only few (4) randomized clinical trials (RCT) have tried to address the clinical efficacy of Impella assistance for the treatment of this very high- risk population, but several large registries and multiple observational studies have demonstrated its safety, feasibility and haemodynamic performance. Although the largest RCT (PROTECT II) have been prematurely stopped due to the risk of futility despite the evidence of more complete revascularization in the Impella arm, the need for an adequate operator’s learning curve must be considered. More recent insights suggest an effect of the device in optimizing end-organ perfusion and improving crucial parameters like renal function. Furthermore, available data suggest that vary early Impella support may improve patient’s outcome in case of cardiogenic shock.


KEY WORDS: Impella - High-risk PCI - Left ventricular support - Axial pump

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Publication History

Article first published online: April 11, 2018
Manuscript accepted: April 4, 2018
Manuscript received: March 19, 2018

Per citare questo articolo

Pesarini G, Gratta A, Dolci G, Lunardi M, Ribichini FL. Impella-protected PCI: the clinical results achieved so far. Minerva Cardioangiol 2018 Apr 11. DOI: 10.23736/S0026-4725.18.04678-9

Corresponding author e-mail

flavio.ribichini@univr.it