Elective versus provisional intraaortic balloon pumping in unprotected left main stenting

Carlo Briguori, Flavio Airoldi, Alaide Chieffo, Matteo Montorfano, Mauro Carlino, Giuseppe Massimo Sangiorgi, Nuccia Morici, Iassen Michev, Ioannis Iakovou, Giuseppe Biondi-Zoccai, Antonio Colombo

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Abstract

Background: Elective intraaortic balloon pump (IABP) may reduce acute complications during unprotected left main (ULM) stenting. However, few data exist on criteria for elective IABP support during ULM stenting. Methods: Since January 1993, 219 consecutive patients underwent elective ULM stenting: 69 had elective IABP support (elective IABP group), whereas 150 patients had conventional procedure (conservative group). Criteria for elective IABP support were (1) lesion located in the distal segment of the left main (bifurcation lesion), (2) left ventricular ejection fraction 6 (identifying high-risk patients) occurred in 38% in the elective IABP group and 13% in the conservative group (P <.001). Severe hemodynamic instability occurred in 12 patients (8%) in the conservative group and in none in the elective IABP group (P = .020). Intraprocedural major adverse cardiac event was higher in the conservative group (9.5% vs 1.5%, P = .032). Elective IABP support (OR 0.08, 95% CI 0.01-0.69, P = .022) and presence of Euroscore >6 plus bifurcation lesion (OR 5.49; 95% CI 1.47-20.51; P = .011) were the independent predictors of intraprocedural events. Conclusions: Elective IABP may prevent intraprocedural events in elective ULM stenting, especially in patients at higher risk.

Original languageEnglish
Pages (from-to)565-572
Number of pages8
JournalAmerican Heart Journal
Volume152
Issue number3
DOIs
Publication statusPublished - Sep 2006

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  • Cardiology and Cardiovascular Medicine

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Elective versus provisional intraaortic balloon pumping in unprotected left main stenting. / Briguori, Carlo; Airoldi, Flavio; Chieffo, Alaide; Montorfano, Matteo; Carlino, Mauro; Massimo Sangiorgi, Giuseppe; Morici, Nuccia; Michev, Iassen; Iakovou, Ioannis; Biondi-Zoccai, Giuseppe; Colombo, Antonio.

In: American Heart Journal, Vol. 152, No. 3, 09.2006, p. 565-572.

Research output: Contribution to journalArticle

Briguori, C, Airoldi, F, Chieffo, A, Montorfano, M, Carlino, M, Massimo Sangiorgi, G, Morici, N, Michev, I, Iakovou, I, Biondi-Zoccai, G & Colombo, A 2006, 'Elective versus provisional intraaortic balloon pumping in unprotected left main stenting', American Heart Journal, vol. 152, no. 3, pp. 565-572. https://doi.org/10.1016/j.ahj.2006.02.024
Briguori, Carlo ; Airoldi, Flavio ; Chieffo, Alaide ; Montorfano, Matteo ; Carlino, Mauro ; Massimo Sangiorgi, Giuseppe ; Morici, Nuccia ; Michev, Iassen ; Iakovou, Ioannis ; Biondi-Zoccai, Giuseppe ; Colombo, Antonio. / Elective versus provisional intraaortic balloon pumping in unprotected left main stenting. In: American Heart Journal. 2006 ; Vol. 152, No. 3. pp. 565-572.
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AU - Airoldi, Flavio

AU - Chieffo, Alaide

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AU - Carlino, Mauro

AU - Massimo Sangiorgi, Giuseppe

AU - Morici, Nuccia

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N2 - Background: Elective intraaortic balloon pump (IABP) may reduce acute complications during unprotected left main (ULM) stenting. However, few data exist on criteria for elective IABP support during ULM stenting. Methods: Since January 1993, 219 consecutive patients underwent elective ULM stenting: 69 had elective IABP support (elective IABP group), whereas 150 patients had conventional procedure (conservative group). Criteria for elective IABP support were (1) lesion located in the distal segment of the left main (bifurcation lesion), (2) left ventricular ejection fraction 6 (identifying high-risk patients) occurred in 38% in the elective IABP group and 13% in the conservative group (P <.001). Severe hemodynamic instability occurred in 12 patients (8%) in the conservative group and in none in the elective IABP group (P = .020). Intraprocedural major adverse cardiac event was higher in the conservative group (9.5% vs 1.5%, P = .032). Elective IABP support (OR 0.08, 95% CI 0.01-0.69, P = .022) and presence of Euroscore >6 plus bifurcation lesion (OR 5.49; 95% CI 1.47-20.51; P = .011) were the independent predictors of intraprocedural events. Conclusions: Elective IABP may prevent intraprocedural events in elective ULM stenting, especially in patients at higher risk.

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