PCI complications: Hemodynamic Support for Complex PCI: Difference between revisions

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===Pathophysiology===
===Pathophysiology===
Rapid [[hemodynamic|hemodynamic deterioration]] and death during [[PCI]] can occur due to [[hypotension]], [[decompensated heart failure]], [[shock]], or [[arrhythmias]].<ref name="pmid34895950">{{cite journal| author=Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM | display-authors=etal| title=2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=J Am Coll Cardiol | year= 2022 | volume= 79 | issue= 2 | pages= e21-e129 | pmid=34895950 | doi=10.1016/j.jacc.2021.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34895950  }} </ref><ref name="pmid20736470">{{cite journal| author=Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman D | display-authors=etal| title=Elective intra-aortic balloon counterpulsation during high-risk percutaneous coronary intervention: a randomized controlled trial. | journal=JAMA | year= 2010 | volume= 304 | issue= 8 | pages= 867-74 | pmid=20736470 | doi=10.1001/jama.2010.1190 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20736470  }} </ref><ref name="pmid22935569">{{cite journal| author=O'Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J | display-authors=etal| title=A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. | journal=Circulation | year= 2012 | volume= 126 | issue= 14 | pages= 1717-27 | pmid=22935569 | doi=10.1161/CIRCULATIONAHA.112.098194 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22935569  }} </ref>
Rapid [[hemodynamic|hemodynamic deterioration]] and death during [[PCI]] can occur due to [[hypotension]], [[decompensated heart failure]], [[shock]], or [[arrhythmias]].<ref name="pmid34895950">{{cite journal| author=Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM | display-authors=etal| title=2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=J Am Coll Cardiol | year= 2022 | volume= 79 | issue= 2 | pages= e21-e129 | pmid=34895950 | doi=10.1016/j.jacc.2021.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34895950  }} </ref><ref name="pmid20736470">{{cite journal| author=Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman D | display-authors=etal| title=Elective intra-aortic balloon counterpulsation during high-risk percutaneous coronary intervention: a randomized controlled trial. | journal=JAMA | year= 2010 | volume= 304 | issue= 8 | pages= 867-74 | pmid=20736470 | doi=10.1001/jama.2010.1190 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20736470  }} </ref><ref name="pmid22935569">{{cite journal| author=O'Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J | display-authors=etal| title=A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. | journal=Circulation | year= 2012 | volume= 126 | issue= 14 | pages= 1717-27 | pmid=22935569 | doi=10.1161/CIRCULATIONAHA.112.098194 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22935569  }} </ref>
===2021 ACA Revascularization Guideline===  
===Prevention===
====Hemodynamic Support Devices====
*Intra-aortic balloon pump
**Can provide minimal [[hemodynamic]] support for [[PCI]] but is capable of improving [[Coronary circulation|coronary]] and [[cerebral blood flow]].<ref name="pmid34895950">{{cite journal| author=Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM | display-authors=etal| title=2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=J Am Coll Cardiol | year= 2022 | volume= 79 | issue= 2 | pages= e21-e129 | pmid=34895950 | doi=10.1016/j.jacc.2021.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=34895950  }} </ref>
**
====2021 ACA Revascularization Guideline====
{|class="wikitable"
{|class="wikitable"
|-
|-
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| bgcolor="LightGreen"|Using an appropriate [[hemodynamic]] support device in the elective settings and among selected [[patients]] is reasonable to [[prevention|prevent]] [[hemodynamic]] compromise during [[PCI]].  
| bgcolor="LightGreen"|Using an appropriate [[hemodynamic]] support device in the elective settings and among selected [[patients]] is reasonable to [[prevention|prevent]] [[hemodynamic]] compromise during [[PCI]].  
|}
|}
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 09:36, 8 July 2022

Hemodynamic Support for Complex PC

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

Pathophysiology

Rapid hemodynamic deterioration and death during PCI can occur due to hypotension, decompensated heart failure, shock, or arrhythmias.[1][2][3]

Prevention

Hemodynamic Support Devices

2021 ACA Revascularization Guideline

Class 2b Recommendation, Level of Evidence: B-R [1]
Using an appropriate hemodynamic support device in the elective settings and among selected patients is reasonable to prevent hemodynamic compromise during PCI.

References

  1. 1.0 1.1 1.2 Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM; et al. (2022). "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". J Am Coll Cardiol. 79 (2): e21–e129. doi:10.1016/j.jacc.2021.09.006. PMID 34895950 Check |pmid= value (help).
  2. Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman D; et al. (2010). "Elective intra-aortic balloon counterpulsation during high-risk percutaneous coronary intervention: a randomized controlled trial". JAMA. 304 (8): 867–74. doi:10.1001/jama.2010.1190. PMID 20736470.
  3. O'Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J; et al. (2012). "A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study". Circulation. 126 (14): 1717–27. doi:10.1161/CIRCULATIONAHA.112.098194. PMID 22935569.