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Review
. 2024 Aug 21;13(16):4931.
doi: 10.3390/jcm13164931.

Role of Mechanical Circulatory Support in Complex High-Risk and Indicated Percutaneous Coronary Intervention: Current Indications, Device Options, and Potential Complications

Francesca Maria Di Muro  1 , Michele Bellino  2 , Luca Esposito  3 , Tiziana Attisano  2 , Francesco Meucci  4 , Alessio Mattesini  4 , Gennaro Galasso  2 , Carmine Vecchione  2   5 , Carlo Di Mario  4
Affiliations
Review

Role of Mechanical Circulatory Support in Complex High-Risk and Indicated Percutaneous Coronary Intervention: Current Indications, Device Options, and Potential Complications

Francesca Maria Di Muro et al. J Clin Med. .

Abstract

Improved expertise and technological advancements have enabled the safe and effective performance of complex and high-risk-indicated percutaneous coronary intervention (CHIP) in patients previously considered inoperable or high-risk. Mechanical circulatory support (MCS) devices play a crucial role in stabilizing hemodynamics during percutaneous coronary intervention (PCI) -related ischemia, thereby reducing the risk of major adverse events and achieving a more complete revascularization. However, the use of MCS devices in protected PCI is not without risks, including peri-procedural myocardial infarction (MI), bleeding, and access-related complications. Despite numerous observational studies, there is a significant lack of randomized clinical trials comparing different MCS devices in various CHIP scenarios and evaluating their long-term safety and efficacy profiles. This review aims to summarize the current evidence regarding the benefits of MCS devices during CHIPs, offer a practical guide for selecting appropriate devices based on clinical scenarios, and highlight the unanswered questions that future trials need to address.

Keywords: CHIP; PCI; mechanical circulatory support.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Complex high-risk indicated percutaneous coronary interventions according to patient clinical characteristics and comorbidities, complexity of coronary artery disease and hemodynamics.
Figure 2
Figure 2
Mechanical Circulatory Support Devices for Complex High-risk Coronary Intervention.
See this image and copyright information in PMC

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