Masiero Giulia, Arturi Federico, Panza Andrea, Tarantini Giuseppe
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, 35128 Padua, Italy.
J Clin Med. 2024 Aug 6;13(16):4586. doi: 10.3390/jcm13164586.
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.
Impella（美国马萨诸塞州丹弗斯市的Abiomed公司生产）微轴泵是一种经皮机械循环支持（MCS）设备，已被证明可增加冠状动脉灌注、降低心肌氧需求并改善外周器官灌注。因此，Impella设备的适应症包括用于心源性休克（CS）的紧急情况以及在高危经皮冠状动脉介入治疗（HR-PCI）期间的预防性植入。然而，尽管在过去十年中它们在心血管实践中的使用呈指数级增长，但支持这种治疗益处的随机证据有限，并且对并发症发生率的担忧日益增加。在本综述中，我们总结了在CS和HR-PCI环境中最广泛使用的Impella CP经皮左心室支持的原理、证据和实际考虑因素，从历史背景到当前问题以及对该设备的未来期望。
