Key result
Percutaneous microaxial flow pumps lack randomized trial support despite rising use and growing complication concerns.
Why the study?
Despite exponential rise in the use of percutaneous microaxial flow pump devices, there are limited randomized clinical trials supporting their benefits and growing concerns regarding complication rates.
This review highlights the limited randomized clinical trial evidence supporting percutaneous microaxial flow pump devices despite their increasing use, alongside growing concerns regarding significant complication rates.
Supports microaxial pump use in high-risk interventions; extends RCT evidence for device selection in shock.
The use of mechanical circulatory support devices in cardiovascular practice has risen exponentially over the past decade. These devices are currently used for hemodynamic support in patients with cardiogenic shock, high-risk percutaneous coronary intervention, left ventricular unloading, protection of kidneys, and right ventricular failure. The Impella (Abiomed) percutaneous microaxial flow pump devices are rapidly gaining popularity. However, despite their increasing use, there are limited randomized clinical trials (RCTs) to support the benefits of the therapy and growing concern regarding complication rates. Vascular problems, including bleeding and acute limb ischemia, are associated with the devices, but published reports also highlight risks for cardiac perforations, mitral chordae rupture, and stroke. In this review, we summarize the history, mechanism of action, previously published RCT data, and upcoming RCTs on these devices.
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Pahuja et al. (2022) conducted a review in Cardiogenic shock, high-risk percutaneous coronary intervention, and ventricular failure. Percutaneous microaxial flow pump devices (Impella) was evaluated. Percutaneous microaxial flow pump devices are increasingly used for hemodynamic support, though limited randomized trial data exists to support their benefits amidst growing concerns over complications.
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