Keywords
percutaneous coronary intervention
coronary artery disease
mechanical circulatory support
periprocedural complications
revascularization
in-hospital mortality
How to Cite
Abstract
Introduction. High-risk percutaneous coronary interventions (PCI) in patients with coronary artery disease (CAD) remain associated with a high incidence of periprocedural complications, particularly in those with severe left ventricular dysfunction and multivessel disease. Intra-aortic balloon counterpulsation (IABC) is one of the main methods of mechanical circulatory support in such cases; however, the optimal strategy for its use remains a matter of debate. The aim of this study was to evaluate the efficacy and safety of prophylactic IABC in patients undergoing high-risk PCI.
Materials and methods. A retrospective analysis was conducted of 42 patients undergoing high-risk PCI with IABC support: 22 patients received prophylactic IABC (P-IABC) and 20 received emergency IABC (E-IABC). Periprocedural complications, completeness of revascularization, and in-hospital mortality were assessed.
Results. The P-IABC group demonstrated significantly higher completeness of revascularization (95.5% vs. 70%, p=0.041) along with a lower incidence of complications compared with the E-IABC group. Specifically, the overall number of vascular complications in the P-IABC group was 25.5% lower (p=0.035) than in the E-IABC group. In addition, patients in the P-IABC group had 25.5% fewer cases of major bleeding (p=0.035), and the need for blood transfusions was 30.5% lower (p=0.047) compared with E-IABC. In-hospital mortality and the incidence of non-Q-wave myocardial infarction in the P-IABC group were also significantly lower – by 34.1% (p=0.018) and 34.9% (p=0.045), respectively, compared with the E-IABC group.
Conclusions. Prophylactic use of IABC in high-risk PCI patients is safe and associated with improved clinical outcomes, reduced periprocedural complications, and lower in-hospital mortality. These findings support the broader implementation of prophylactic IABC in clinical practice.
References
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