Effect of Extracorporeal Membrane Oxygenation Support on Complex High-Risk Elective Percutaneous Coronary Intervention: A Clinical Research Review of Progress and Outcomes

Background: The landscape of percutaneous coronary intervention (PCI) has expanded to encompass complex high-risk elective cases, necessitating advanced support strategies to mitigate procedural challenges and ensure patient safety. In this review manuscript, the effect of extracorporeal membrane oxygenation (ECMO) support on complex high-risk elective PCI was critically evaluated through an analysis of relevant clinical studies. The objective is to elucidate the role of ECMO in optimizing procedural success, mitigating complications, and improving long-term patient outcomes in this high-stake domain of interventional cardiology. Methods: A comprehensive search strategy identified seven publications encompassing single-center prospective, retrospective, and case report designs, collectively involving 91 patients undergoing high-risk elective PCI with ECMO support. Results: The results from these studies demonstrated the potential of ECMO support to facilitate successful high-risk elective PCI with favorable procedural outcomes, highlighting the importance of careful patient selection and proactive management of potential complications to further optimize the use of ECMO in this clinical setting. The refinement of patient selection criteria, optimization of procedural techniques, and assessment of long-term clinical outcomes following ECMO-assisted high-risk PCI procedures represent crucial avenues for future research. Conclusions: Overall, the reviewed evidence supports the notion that ECMO represents a valuable tool for providing hemodynamic support during high-risk PCI procedures, particularly in patients deemed at very high risk for surgical revascularization.