Boudoulas Konstantinos Dean, Pederzolli Andrew, Saini Uksha, Gumina Richard J, Mazzaferri Ernest L, Davis Michael, Bush Charles A, Capers Quinn, Magorien Raymond, Pompili Vincent J
Division of Cardiovascular Medicine, Section of Interventional Cardiology, The Ohio State University, Columbus, Ohio 43210, USA.
Acute Card Care. 2012 Dec;14(4):120-4. doi: 10.3109/17482941.2012.741244.
Compare vascular complications and incidence of bleeding of Impella 2.5 and intra-aortic balloon pump (IABP) in high-risk percutaneous coronary interventions (PCI).
Large arterial sheath size for device insertion is associated with vascular and/or bleeding complications; gastrointestinal bleeding may also occur with anti-coagulation use.
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.
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.
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.
比较在高危经皮冠状动脉介入治疗（PCI）中，Impella 2.5与主动脉内球囊反搏（IABP）的血管并发症及出血发生率。
用于装置插入的大动脉鞘尺寸与血管和/或出血并发症相关；使用抗凝剂时也可能发生胃肠道出血。
研究在高危PCI期间接受Impella 2.5或IABP治疗的急性冠状动脉综合征患者（13例使用Impella；62例使用IABP）。比较血管并发症及出血发生率。
两组术后血细胞比容相似。Impella组和IABP组分别有38.4%和32.2%的患者接受输血（P = 无显著性差异）；出血分别有65.3%、30.7%和3.8%是由于血管穿刺部位/手术相关、胃肠道和泌尿生殖系统所致。Impella组和IABP组的血管并发症无统计学显著差异（分别为15.3%和6.4%的患者）；肠系膜缺血（n = 1）和主动脉破裂（n = 1）仅发生在IABP组。两组间住院期间及1年死亡率无统计学显著差异。
在高危PCI期间，Impella与IABP使用安全性相似，血管和出血并发症相近。重要的是，约三分之一的出血来自胃肠道系统，需要采取谨慎的预防措施并进行监测。
