Background Elective intraaortic balloon pump (IABP) may reduce acute complications during unprotected left main (ULM) stenting. However, few data exist on criteria for elective IABP support during ULM stenting. Methods Since January 1993, 219 consecutive patients underwent elective ULM stenting: 69 had elective IABP support (elective IABP group), whereas 150 patients had conventional procedure (conservative group). Criteria for elective IABP support were (1) lesion located in the distal segment of the left main (bifurcation lesion), (2) left ventricular ejection fraction < 40%, (3) atherectomy, (4) unstable angina, and (5) critical disease of the right coronary artery. Incidence of intraprocedural major adverse cardiac events (eg, severe hypotension and/or shock, myocardial infarction, urgent bypass surgery, and death) was assessed. Results Euroscore > 6 (identifying high-risk patients) occurred in 38% in the elective IABP group and 13% in the conservative group (P < .001). Severe hemodynamic instability occurred in 12 patients (8%) in the conservative group and in none in the elective IABP group (P = .020). Intraprocedural major adverse cardiac event was higher in the conservative group (9.5% vs 1.5%, P =.032). Elective IABP support (OR 0.08, 95% CI 0.01-0.69, P = .022) and presence of Euroscore > 6 plus bifurcation lesion (OR 5.49; 95% CI 1.47-20.5 1; P = .011) were the independent predictors of. intraprocedural events. Conclusions Elective IABP may prevent intraprocedural events in elective ULM stenting, especially in patients at higher risk.

Elective versus provisional intraaortic balloon pumping in unprotected left main stenting / Carlo, Briguori; Flavio, Airoldi; Alaide, Chieffo; Matteo, Montorfano; Mauro, Carlino; G. M., Sangiorgi; Nuccia, Morici; Iassen, Michev; Ioannis, Iakovou; BIONDI ZOCCAI, Giuseppe; Antonio, Colombo. - In: AMERICAN HEART JOURNAL. - ISSN 0002-8703. - STAMPA. - 152:3(2006), pp. 565-572. [10.1016/j.ahj.2006.02.024]

Elective versus provisional intraaortic balloon pumping in unprotected left main stenting

BIONDI ZOCCAI, GIUSEPPE;
2006

Abstract

Background Elective intraaortic balloon pump (IABP) may reduce acute complications during unprotected left main (ULM) stenting. However, few data exist on criteria for elective IABP support during ULM stenting. Methods Since January 1993, 219 consecutive patients underwent elective ULM stenting: 69 had elective IABP support (elective IABP group), whereas 150 patients had conventional procedure (conservative group). Criteria for elective IABP support were (1) lesion located in the distal segment of the left main (bifurcation lesion), (2) left ventricular ejection fraction < 40%, (3) atherectomy, (4) unstable angina, and (5) critical disease of the right coronary artery. Incidence of intraprocedural major adverse cardiac events (eg, severe hypotension and/or shock, myocardial infarction, urgent bypass surgery, and death) was assessed. Results Euroscore > 6 (identifying high-risk patients) occurred in 38% in the elective IABP group and 13% in the conservative group (P < .001). Severe hemodynamic instability occurred in 12 patients (8%) in the conservative group and in none in the elective IABP group (P = .020). Intraprocedural major adverse cardiac event was higher in the conservative group (9.5% vs 1.5%, P =.032). Elective IABP support (OR 0.08, 95% CI 0.01-0.69, P = .022) and presence of Euroscore > 6 plus bifurcation lesion (OR 5.49; 95% CI 1.47-20.5 1; P = .011) were the independent predictors of. intraprocedural events. Conclusions Elective IABP may prevent intraprocedural events in elective ULM stenting, especially in patients at higher risk.
2006
01 Pubblicazione su rivista::01a Articolo in rivista
Elective versus provisional intraaortic balloon pumping in unprotected left main stenting / Carlo, Briguori; Flavio, Airoldi; Alaide, Chieffo; Matteo, Montorfano; Mauro, Carlino; G. M., Sangiorgi; Nuccia, Morici; Iassen, Michev; Ioannis, Iakovou; BIONDI ZOCCAI, Giuseppe; Antonio, Colombo. - In: AMERICAN HEART JOURNAL. - ISSN 0002-8703. - STAMPA. - 152:3(2006), pp. 565-572. [10.1016/j.ahj.2006.02.024]
File allegati a questo prodotto
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/433901
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 9
  • Scopus 72
  • ???jsp.display-item.citation.isi??? 53
social impact