Key result
Surgically implanted axillary Impella 5.5 with VA-ECMO yielded similar hospital survival (61.5% vs 53.8%, P=0.691) but lower device complications (7.7% vs 46.1%, P=0.021) than Impella CP or 2.5.
Why the study?
Little is known about the safety and efficacy of Impella 5.5 compared to previous iterations when combined with veno-arterial extracorporeal membrane oxygenation as ECPELLA.
Does Impella 5.5 compared to Impella CP or 2.5 improve hemodynamics and reduce complications in patients receiving ECPELLA for cardiogenic shock?
Cohort (n=26)
Does Impella 5.5 compared to Impella CP or 2.5 improve hemodynamics and reduce complications in patients receiving ECPELLA for cardiogenic shock?
Absolute Event Rate: 61.5% vs 53.8%
p-value: p=0.691
In patients with cardiogenic shock requiring ECPELLA, the use of axillary Impella 5.5 provides greater hemodynamic support and fewer device-related complications compared to femoral Impella CP or 2.5.
May support higher-flow ECPELLA configurations; leaves open prospective confirmation of safety and outcomes.
BACKGROUND: Little is known about safety and efficacy of the use of Impella 5.5 compared to previous iterations in the setting of Impella with Veno-Arterial Extracorporeal Membrane Oxygenation Support as ECPELLA. METHODS: Consecutive patients who were treated by ECPELLA with surgically implanted axillary Impella 5.5 (N = 13) were compared with patients supported by ECPELLA with percutaneous femoral Impella CP or 2.5 (Control, N = 13). RESULTS: The total ECPELLA flow was higher in ECPELLA 5.5 group (6.9 vs. 5.4 L/min, p = 0.019). Actual hospital survival was higher than predicted and comparable in both groups (ECPELLA 5.5, 61.5% vs. Control, 53.8%, p = 0.691). Both total device complications (ECPELLA 5.5, 7.7% vs. Control, 46.1%, p = 0.021) and Impella-specific complications (ECPELLA 5.5, 0% vs. Control, 30.8%, p = 0.012) were significantly lower in the ECPELLA 5.5 group. CONCLUSIONS: Utilization of Impella 5.5 in the setting of ECPELLA provides greater hemodynamic support with a lower risk of complications compared to Impella CP or 2.5.
No takes yet. Share an insight, caveat, or question.
Isath et al. (2023) conducted a cohort in Cardiogenic shock (n=26). Surgically implanted axillary Impella 5.5 vs. Percutaneous femoral Impella CP or 2.5 was evaluated on Hospital survival (p=0.691). Surgically implanted axillary Impella 5.5 with VA-ECMO yielded similar hospital survival (61.5% vs 53.8%, P=0.691) but lower device complications (7.7% vs 46.1%, P=0.021) than Impella CP or 2.5.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: