High-Risk PCI Patients Need Standby IABP Strategy

Cheryl Clark, August 27, 2010

Use of an increasingly common percutaneous coronary intervention of inserting an intra-aortic balloon pump  (IABP) to improve blood flow prior to patients undergoing stent placement did not lower rates of repeat procedures, heart attacks or death, said London researchers who conducted a randomized trial of the device in 301 patients who underwent the elective procedure.

"The study did not demonstrate a difference in major adverse cardiac and cardiovascular events (MACCE) at hospital discharge, and therefore does not support routine elective IABP insertion before high-risk percutaneous coronary intervention," concluded the authors, affiliated with King's College and several other institutions in the United Kingdom.

The study was published in this week's issue of the Journal of the American Medical Association.

The reason to use these pumps was that in some patients with severely impaired left ventricular function, insertion of a stent can increase risk of illness and death. They may not be able to withstand consequences of ischemia or arrhythmias that may occur during the procedure.

The idea was that these pumps could provide hemodynamic support through a special pump connected to a balloon-type device inserted into the descending aorta.

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