title: Supported high-risk percutaneous coronary intervention with the Impella 2.5 device the Europella registry.
abstract: OBJECTIVE
  This retrospective multicenter registry evaluated the safety and feasibility of left ventricular (LV) support with the Impella 2.5 (Abiomed Europe GmbH, Aachen, Germany) during high-risk percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  Patients with complex or high-risk coronary lesions, such as last remaining vessel or left main lesions, are increasingly being treated with PCI. Because periprocedural hemodynamic compromise and complications might occur rapidly, many of these high-risk procedures are being performed with mechanical cardiac assistance, particularly in patients with poor LV function. The Impella 2.5, a percutaneous implantable LV assist device, might be a superior alternative to the traditionally used intra-aortic balloon pump.
  
  
  METHODS
  The Europella registry included 144 consecutive patients who underwent a high-risk PCI. Safety and feasibility end points included incidence of 30-day adverse events and successful device function.
  
  
  RESULTS
  Patients were older (62% >70 years of age), 54% had an LV ejection fraction < or = 30%, and the prevalence of comorbid conditions was high. Mean European System for Cardiac Operative Risk Evaluation score was 8.2 (SD 3.4), and 43% of the patients were refused for coronary artery bypass grafting. A PCI was considered high-risk due to left main disease, last remaining vessel disease, multivessel coronary artery disease, and low LV function in 53%, 17%, 81%, and 35% of the cases, respectively. Mortality at 30 days was 5.5%. Rates of myocardial infarction, stroke, bleeding requiring transfusion/surgery, and vascular complications at 30 days were 0%, 0.7%, 6.2%, and 4.0%, respectively.
  
  
  CONCLUSIONS
  This large multicenter registry supports the safety, feasibility, and potential usefulness of hemodynamic support with Impella 2.5 in high-risk PCI.
authors.affiliation: Academic Medical Center-University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Krischan D
authors.initials: KD
authors.lastname: Sjauw
authors.forename: Thomas
authors.initials: T
authors.lastname: Konorza
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Paolo L
authors.initials: PL
authors.lastname: Danna
authors.forename: Maurizio
authors.initials: M
authors.lastname: Viecca
authors.forename: Hans-Heinrich
authors.initials: HH
authors.lastname: Minden
authors.forename: Christian
authors.initials: C
authors.lastname: Butter
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.forename: Christian
authors.initials: C
authors.lastname: Hassager
authors.forename: Francisco P
authors.initials: FP
authors.lastname: Machado
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pedrazzini
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Wagner
authors.forename: Rainer
authors.initials: R
authors.lastname: Schamberger
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kerber
authors.forename: Detlef G
authors.initials: DG
authors.lastname: Mathey
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
authors.forename: Annemarie E
authors.initials: AE
authors.lastname: Engström
authors.forename: Jose P S
authors.initials: JP
authors.lastname: Henriques
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001803:Blood Transfusion / Q000706:statistics & numerical data; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy*; D005060:Europe / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006353:Heart-Assist Devices; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000628:therapy*