Consistency of effectiveness between prophylactic use of IABP and VA-ECMO in interventional treatment of complex high-risk coronary lesions
Objective:To compare the impact of intra-aortic balloon pump(IABP)and veno-arterial extracorporeal membrane oxygenation(VA-ECMO)on clinical outcomes,including mortality and major adverse cardiac events(MACE),in patients with complex high-risk coronary artery disease(CHIP)undergoing percutaneous coronary intervention.Methods:This single-center retrospective study included 24 CHIP patients who were either unsuitable for or declined surgical interven-tion and received mechanical circulatory support with either IABP or VA-ECMO.Patients were divided into an IABP group(18 cases)and a VA-ECMO group(6 cases).Clinical outcomes,including MACE,perioperative mortality,in-hospital mortality,and 30-day mortality,were compared between the two groups.Results:Baseline characteristics were well balanced between the two groups.There was no statistically significant difference in the incidence of hemodynamic instability between the two groups(11.1％vs.16.7％;P=0.78).The composite outcome of MACE showed no statistically significant differ-ence between the groups(38.9％vs.33.3％;P=0.64).The perioperative mortality rate was 27.8％in the IABP group and 33.3％in the VA-ECMO group,and the difference was not statistically significant(P=0.72).The in-hospital mortali-ty and 30-day mortality rates were consistent between the two groups,with 38.9％in the IABP group and 33.3％in the VA-ECMO group,and the difference was not statistically significant between the two groups(P=0.64).The mean length of hospital stay was longer in the VA-ECMO group(P=0.02).Conclusion:The use of IABP or VA-ECMO as mechanical circulatory support during CHIP procedures did not significantly differ in terms of hemodynamic stability or overall MACE out-comes.The choice between IABP and VA-ECMO may not significantly impact long-term survival outcomes in CHIP patients.
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