Impella devices: a comprehensive review of their development, use, and impact on cardiogenic shock and high-risk percutaneous coronary intervention.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 Epub Date: 2023-08-08 DOI:10.1080/14779072.2023.2244874
Tzvi Fishkin, Ameesh Isath, Edmund Naami, Wilbert S Aronow, Avi Levine, Alan Gass
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Abstract

Introduction: Impella devices have emerged as a critical tool for temporary mechanical circulatory support (TMCS) in the management of cardiogenic shock (CS) and high-risk percutaneous coronary interventions (PCI). The purpose of this review is to examine the history of the different Impella devices, their hemodynamic profiles, and how the data supports their use.

Areas covered: This review covers the development and specifications of the Impella 2.5, Impella CP, Impella 5.0/Left Direct (LD), Impella RP, and Impella 5.5 devices. This review also covers the clinical trials that illuminate the Impella devices' use in their appropriate clinical contexts. These studies examine the effectiveness of Impella devices and have begun to yield promising results, demonstrating improved survival rates when compared to the historically high mortality rates associated with CS. It is important to weigh the benefits of Impella devices in light of their contraindications. A literature search was conducted by searching the PubMed database for reviews, meta-analyses, and clinical trials pertinent to Impella devices.

Expert opinion: Impella devices are a crucial tool for management of patients undergoing high-risk PCI and those with CS. There is evidence that early Impella implantation is beneficial in the treatment of patients presenting with CS. Further randomized controlled trials are needed to better elucidate the benefits of Impella devices in various clinical settings.

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Impella装置:对其发展、使用以及对心源性休克和高危经皮冠状动脉介入治疗的影响的全面综述。
引言:在心源性休克(CS)和高风险经皮冠状动脉介入治疗(PCI)中,Impella装置已成为临时机械循环支持(TMCS)的关键工具。本综述的目的是检查不同Impella装置的历史、其血液动力学特征以及数据如何支持其使用。涵盖的领域:本综述涵盖Impella 2.5、Impella CP、Impilla 5.0/Left Direct(LD)、Impella RP和Impella 5.5设备的开发和规格。这篇综述还涵盖了阐明Impella设备在其适当临床环境中使用的临床试验。这些研究检验了Impella装置的有效性,并已开始产生有希望的结果,表明与CS相关的历史高死亡率相比,存活率有所提高。根据其禁忌症权衡Impella装置的益处是很重要的。通过在PubMed数据库中搜索与Impella设备相关的综述、荟萃分析和临床试验,进行文献检索。专家意见:Impella设备是治疗高危PCI患者和CS患者的重要工具。有证据表明,早期植入Impella对CS患者的治疗是有益的。需要进一步的随机对照试验来更好地阐明Impella设备在各种临床环境中的益处。
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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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