Impella is a catheter-based micro-axial flow pump placed across the aortic valve, and it is currently the only percutaneous left ventricular assist device approved for high-risk percutaneous coronary intervention and cardiogenic shock. Areas Covered: Even though several studies have repeatedly demonstrated the excellent hemodynamic profile of Impella in high-risk settings, it remains underutilized. Here we aim to provide an up-to-date summary of the available literature on Impellas use in High risk settings as well as the practical aspects of its usage. Expert Commentary: Percutaneous coronary interventions in high rsk settings have always been challenging for a physician. Impella 2.5 and CP, have been proven safe, cost effective and feasible in High Risk Percutaneous coronary Interventions with an excellent hemodynamic profile.
Keywords: Percutaneous coronary interventions: PCI; acute myocardial infarction with cardiogenic shock: AMICS; cardiogenic shock: CS; high-risk percutaneous coronary interventions: HRPCI; intra-aortic balloon pump: IABP; mechanical circulatory support: MCS; percutaneous ventricular assist device: pVAD; refractory cardiac arrest: RCA.