Short term outcomes of Impella circulatory support for high-risk percutaneous coronary intervention a systematic review and meta-analysis

Catheter Cardiovasc Interv. 2022 Jan 1;99(1):27-36. doi: 10.1002/ccd.29757. Epub 2021 May 24.

Abstract

Objective: Aim of this study is to evaluate short term safety and efficacy of Impella in high risk percutaneous coronary intervention (HR-PCI) population.

Background: While several studies demonstrated the clinical significance of Impella in HR-PCI, few data exist about its impact on short term outcome.

Methods: All studies reporting short term outcomes of PCI with any Impella device were included. The primary endpoint was either in-hospital or 30-day mortality, while vascular complications, post-procedural stroke, post-procedural dialysis and bleeding complications were assessed as secondary outcomes.

Results: Nine studies with 7448 patients were included. Median age was 69.5 years old (67-73), with a mean ejection fraction of 29.7% (20%-39%) and a Syntax score of 30.2 (25. 5-33, interquartile [IQR]). Impella 2.5 was the most commonly used axial flow pump used to support these PCIs (88.7%). In-hospital death was observed in 5.09% of patients (95% confidence interval [CI] 3.69-6.49, I2 = 78%), while vascular complications in 2.53% of patients (1.07-4.00, I2 = 89%) and post-procedural stroke in 2.77% of patients (0.50-6.05, I2 = 98%). Major bleeding occurred in 5.98% of patients (3.66-8.31, I2 = 90%) and post-procedural dialysis in 4.44% of patients (1.50-7.37, I2 = 93% all CI 93%).

Conclusion: Use of Impella in high risk PCI appears to have an acceptable rate of complication, especially regarding vascular complications and major bleedings.

Keywords: Impella; high risk PCI; left ventricle; mechanical support device.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Aged
  • Heart-Assist Devices* / adverse effects
  • Hospital Mortality
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Retrospective Studies
  • Stroke Volume
  • Treatment Outcome

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