Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention: Vascular complications and incidence of bleeding

Konstantinos Dean Boudoulas, Andrew Pederzolli, Uksha Saini, Richard J. Gumina, Ernest L. Mazzaferri, Michael Davis, Charles A. Bush, Quinn Capers IV, Raymond Magorien, Vincent J. Pompili

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective: Compare vascular complications and incidence of bleeding of Impella 2.5 and intra-aortic balloon pump (IABP) in high-risk percutaneous coronary interventions (PCI). Background: Large arterial sheath size for device insertion is associated with vascular and/or bleeding complications; gastrointestinal bleeding may also occur with anti-coagulation use. Methods: Patients with an acute coronary syndrome receiving Impella 2.5 or IABP during high-risk PCI were studied (13 Impella; 62 IABP). Vascular complications and incidence of bleeding were compared. Results: Post-procedure hematocrit was similar between groups. Blood transfusion occurred in 38.4% and 32.2% of patients in the Impella and IABP groups, respectively (P = NS); 65.3%, 30.7% and 3.8% of bleeding were due to vascular access site/procedure related, gastrointestinal and genitourinary, respectively. There was no statistical significant difference in vascular complications between the Impella and IABP groups (15.3% and 6.4% of patients, respectively); mesenteric ischemia (n = 1) and aortic rupture (n = 1) were only in the IABP group. In-hospital and one-year mortality were not statistically significant between groups. Conclusion: Impella can be used as safely as IABP during high-risk PCI with similar vascular and bleeding complications. Importantly, approximately one third of bleeding was from the gastrointestinal system warranting careful prophylactic measures and monitoring.

Original languageEnglish (US)
Pages (from-to)120-124
Number of pages5
JournalAcute Cardiac Care
Volume14
Issue number4
DOIs
StatePublished - Dec 1 2012

Keywords

  • Impella
  • Intra-aortic balloon pump
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Boudoulas, K. D., Pederzolli, A., Saini, U., Gumina, R. J., Mazzaferri, E. L., Davis, M., Bush, C. A., Capers IV, Q., Magorien, R., & Pompili, V. J. (2012). Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention: Vascular complications and incidence of bleeding. Acute Cardiac Care, 14(4), 120-124. https://doi.org/10.3109/17482941.2012.741244