Background: We present the indications for use, temporal trends, complications, and 1-year clinical outcomes after single-access percutaneous mechanical circulatory support device placement from years 2009-2015 at our institution.
Methods and results: Patients with an intraaortic balloon pump (IABP) or Impella device placed in the catheterization suite between January 1, 2009 and December 31, 2015 were included. There were a total of 778 patients in this study. The mean number of devices placed per year was 111. There was no statistically significant trend in total number of devices placed overall, but the rate of Impella placement declined over time (P=.02). There was a significant trend toward less use before high-risk percutaneous coronary intervention (PCI) (P=.04). The composite secondary endpoint occurred in 59.4% of patients, with no significant difference between patients treated with an IABP or Impella (P=.66). There were 37 device-related complications, which occurred more commonly with the Impella (12.5%) than with the IABP (3.7%; P<.01).
Conclusions: There was no significant overall change in the total number of devices placed per year, but we did observe a decreased use of Impella support. There was a significant decrease in the utilization of percutaneous mechanical circulatory support prior to high-risk PCI, driven primarily by a decreased usage of the IABP. There were more complications related to the Impella device vs the IABP, with no improvement in the composite outcome.