Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Aug 6;13(16):4586.
doi: 10.3390/jcm13164586.

Mechanical Circulatory Support with Impella: Principles, Evidence, and Daily Practice

Giulia Masiero  1 , Federico Arturi  1 , Andrea Panza  1 , Giuseppe Tarantini  1
Affiliations
Review

Mechanical Circulatory Support with Impella: Principles, Evidence, and Daily Practice

Giulia Masiero et al. J Clin Med. .

Abstract

The Impella (Abiomed, Danvers, MA, USA) microaxial pump is a percutaneous mechanical circulatory support (MCS) that has been shown to increase coronary perfusion, reduce myocardial oxygen demand, and improve peripheral organ perfusion. Therefore, indications for the Impella device include emergency use for cardiogenic shock (CS) and pre-emptive implantation during high-risk percutaneous coronary intervention (HR-PCI). However, despite their exponential use in cardiovascular practice over the past decade, there is limited randomized evidence to support the benefits of this therapy and growing concern regarding complication rates. In this review, we summarize the principles, evidence, and practical considerations of the most widely used Impella CP percutaneous left ventricular support in both CS and HR-PCI settings, moving from the historical background to current issues and future expectations for this device.

Keywords: cardiogenic shock; high-risk percutaneous coronary intervention; mechanical circulatory support; percutaneous left ventricular assist devices.

PubMed Disclaimer

Conflict of interest statement

GT received speakers’ fees from Abiomed and GADA; all other authors declare no conflicts of interest regarding this publication.

Figures

Figure 1
Figure 1
Suggested best practice in percutaneous Impella CP use. HR-PCI, high-risk PCI; HT, heart team; CS, cardiogenic shock; SCAI, Society for Cardiovascular Angiography and Interventions; ECMO, extracorporeal veno-arterial membrane oxygenation; LV, left ventricle; AC, anticoagulation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Thiele H., Zeymer U., Neumann F.-J., Ferenc M., Olbrich H.-G., Hausleiter J., Richardt G., Hennersdorf M., Empen K., Fuernau G., et al. Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock. N. Engl. J. Med. 2012;367:1287–1296. doi: 10.1056/NEJMoa1208410. - DOI - PubMed
    1. Lüsebrink E., Kellnar A., Krieg K., Binzenhöfer L., Scherer C., Zimmer S., Schrage B., Fichtner S., Petzold T., Braun D., et al. Percutaneous Transvalvular Microaxial Flow Pump Support in Cardiology. Circulation. 2022;145:1254–1284. doi: 10.1161/CIRCULATIONAHA.121.058229. - DOI - PubMed
    1. Pahuja M., Johnson A., Kabir R., Bhogal S., Wermers J.P., Bernardo N.L., Ben-Dor I., Hashim H., Satler L.F., Sheikh F.H., et al. Randomized Trials of Percutaneous Microaxial Flow Pump Devices. J. Am. Coll. Cardiol. 2022;80:2028–2049. doi: 10.1016/j.jacc.2022.08.807. - DOI - PubMed
    1. Burkhoff D., Sayer G., Doshi D., Uriel N. Hemodynamics of Mechanical Circulatory Support. J. Am. Coll. Cardiol. 2015;66:2663–2674. doi: 10.1016/j.jacc.2015.10.017. - DOI - PubMed
    1. Chieffo A., Dudek D., Hassager C., Combes A., Gramegna M., Halvorsen S., Huber K., Kunadian V., Maly J., Møller J.E., et al. Joint EAPCI/ACVC expert consensus document on percutaneous ventricular assist devices. EuroIntervention. 2021;17:e274–e286. doi: 10.4244/EIJY21M05_01. - DOI - PMC - PubMed

LinkOut - more resources