LAUSR

BACKGROUND Patients and mechanical circulatory support assortment, as well as peri-procedural and post-procedural clinical outcomes in complex, high-risk percutaneous coronary interventions (PCIs), underpinned by percutaneous left ventricle assist devices (pLVAD), are a disputable debate. AIM The aim of the study was to seek differences between patients qualified for complex, high-risk PCIs with an intra-aortic balloon pump (IABP) or Impella pump support, and to compare peri- and post-procedural clinical outcomes. METHODS The presented analysis is a single-centre study, which comprised consecutive patients undergoing complex, high-risk PCIs performed with the pLVAD, either IABP or Impella. Patients included in the current analysis were recruited between January 2018 and December 2021. There were 28 (56%) patients in the Impella group and 22 (44%) in the IABP group. The primary endpoints comprised overall mortality and major adverse cardiovascular events (MACE). These included all-cause mortality, myocardial infarction, revascularisation and cerebrovascular events. RESULTS Patients from the IABP group were significantly older, had higher left ventricular ejection fraction and less frequent history of PCI, while the in-hospital risk of death assessed by Euroscore II remained similar in the Impella and IABP groups median (interquartile range [IQR]) (2.8 [2-3.8] vs. 2.5 [1.8-5.2], P = 0.73). Patients undergoing complex, high-risk PCIs with pLVAD support presented similar results during the follow-up, assessed by log-rank estimates in terms of MACE (p = 0.41) and mortality rate (p = 0.65). CONCLUSIONS The use of pLVAD devices in patients undergoing complex, high-risk PCIs, with reduced left ventricular ejection fraction, is a promising treatment option for patients disqualified for surgery cardiac surgeons.