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Mechanical Circulatory Support for High-Risk Percutaneous Coronary Intervention

  • Myocardial Disease (A Abbate and M Merlo, Section Editors)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review will focus on the indications of mechanical circulatory support (MCS) for high-risk percutaneous coronary intervention (PCI) and then analyze in detail all MCS devices available to the operator, evaluating their mechanisms of action, pros and cons, contraindications, and clinical data supporting their use.

Recent Findings

Over the last decade, the interventional cardiology arena has witnessed an increase in the complexity profile of the patients and lesions treated in the catheterization laboratory. Patients with significant comorbidity burden, left ventricular dysfunction, impaired hemodynamics, and/or complex coronary anatomy often cannot tolerate extensive percutaneous revascularization. Therefore, a variety of MCS devices have been developed and adopted for high-risk PCI.

Summary

Despite the variety of MCS available to date, a detailed characterization of the patient requiring MCS is still lacking. A precise selection of patients who can benefit from MCS support during high-risk PCI and the choice of the most appropriate MCS device in each case are imperative to provide extensive revascularization and improve patient outcomes. Several new devices are being tested in early feasibility studies and randomized clinical trials and the experience gained in this context will allow us to provide precise answers to these questions in the coming years.

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Data Availability

No datasets were generated or analysed during the current study.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Washington, 1959 NE Pacific St, Box 356422, Seattle, WA, 98195, USA

    Silvia Moscardelli, Reza Masoomi & Lorenzo Azzalini

  2. University of Milan, Milan, Italy

    Silvia Moscardelli

  3. Division of Cardiology, Henry Ford Hospital, Detroit, MI, USA

    Pedro Villablanca & Ahmad Jabri

  4. Division of Cardiology, Department of Medicine, Hackensack University Medical Center, Hackensack, NJ, USA

    Ankitkumar K. Patel

  5. Robert M. Berne Cardiovascular Research Center, and Division of Cardiology, University of Virginia, Charlottesville, VA, USA

    Francesco Moroni

  6. Cardiovascular Division, Medicine Department, University Milano-Bicocca, Milan, Italy

    Francesco Moroni

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Contributions

S.M. and F.M. wrote the main manuscript text and R.M. and A.J. prepared figures and tables. All authors reviewed the manuscript.

Corresponding author

Correspondence to Lorenzo Azzalini.

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Conflict of Interests

Dr. Villablanca received consulting fees from Abiomed, Livanova, Edwards, Teleflex, and Angiodynamic. Dr. Patel received consulting fees from Medtronic, Abiomed, Abbott Vascular, Edwards Lifesciences, Shockwave, and Heartflow; serves on the advisory board of Abiomed and Medtronic. Dr. Azzalini received consulting fees from Teleflex, Abiomed, GE Healthcare, Abbott Vascular, Reflow Medical, and Cardiovascular Systems, Inc.; serves on the advisory board of Abiomed and GE Healthcare; and owns equity in Reflow Medical. The other authors have no disclosures.

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Moscardelli, S., Masoomi, R., Villablanca, P. et al. Mechanical Circulatory Support for High-Risk Percutaneous Coronary Intervention. Curr Cardiol Rep 26, 233–244 (2024). https://doi.org/10.1007/s11886-024-02029-2

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