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

13 Citations (Scopus)

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

Fingerprint

Percutaneous Coronary Intervention
Blood Vessels
Hemorrhage
Incidence
Aortic Rupture
Acute Coronary Syndrome
Hematocrit
Blood Transfusion
Equipment and Supplies
Mortality

Keywords

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

ASJC Scopus subject areas

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

Cite this

Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention : Vascular complications and incidence of bleeding. / Boudoulas, Konstantinos Dean; Pederzolli, Andrew; Saini, Uksha; Gumina, Richard J; Mazzaferri, Ernest L.; Davis, Michael; Bush, Charles A.; Capers IV, Quinn; Magorien, Raymond; Pompili, Vincent J.

In: Acute Cardiac Care, Vol. 14, No. 4, 01.12.2012, p. 120-124.

Research output: Contribution to journalArticle

Boudoulas, KD, Pederzolli, A, Saini, U, Gumina, RJ, Mazzaferri, EL, Davis, M, Bush, CA, Capers IV, Q, Magorien, R & Pompili, VJ 2012, 'Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention: Vascular complications and incidence of bleeding', Acute Cardiac Care, vol. 14, no. 4, pp. 120-124. https://doi.org/10.3109/17482941.2012.741244
Boudoulas, Konstantinos Dean ; Pederzolli, Andrew ; Saini, Uksha ; Gumina, Richard J ; Mazzaferri, Ernest L. ; Davis, Michael ; Bush, Charles A. ; Capers IV, Quinn ; Magorien, Raymond ; Pompili, Vincent J. / Comparison of Impella and intra-aortic balloon pump in high-risk percutaneous coronary intervention : Vascular complications and incidence of bleeding. In: Acute Cardiac Care. 2012 ; Vol. 14, No. 4. pp. 120-124.
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