Latest news with #Impella
Medscape
05-05-2025
- Health
- Medscape
New Safety Questions Over Mechanical Circulatory Support
For circulatory support in cardiogenic shock, the best choice between Impella and intra-aortic balloon pump (IABP) has been controversial. Now, new data is complicating the debate. Presenting at the Society for Cardiovascular Angiography and Interventions in Washington, DC, Godbless Ajenaghughrure, MD, an internist and resident at Trihealth Good Samaritan Hospital in Cincinnati, Ohio, reported that Impella use is associated with higher 30-day mortality compared to IABP. The new propensity-matched analysis shows that Impella use at 1 month is linked to significantly higher all-cause mortality (42.3%) compared with IABP (29.6%; hazard ratio [HR], 1.594; 95% CI, 1.396-1.820; P < .001). Cardiac Arrest and Sepsis Patients treated with Impella also had higher rates of cardiac arrest (33.9% vs 26.8%; HR, 1.310; 95% CI, 1.135-1.511; P < .001) and sepsis (14.6% vs 12.3%; HR, 1.410; 95% CI, 1.070-1.858; P = .024). There were no significant differences in rates of acute kidney injury (14.6% vs 12.3%; P = .090), cerebral infarction (10.1% vs 8.4%; P = .130), atrial fibrillation (27.7% vs 27.1%; P = .754), ventricular tachycardia (21.8% vs 23.7%; P = .254), or gastrointestinal bleeding (12.8% vs 12.4%; P = .689). Researchers used the large healthcare database TriNetX to conduct the analysis comparing 30-day outcomes between patients who received either Impella (n = 1256) or IABP (n = 1256) support for cardiogenic shock. Patients were well-matched for heart failure, atrial fibrillation, diabetes, chronic kidney disease, and prior myocardial infarction, the authors report. Cardiogenic shock affects between 40,000 and 50,000 people in the US a year and is the leading cause of in-hospital mortality after acute myocardial infarction. One-year mortality rates are as high as 50%. In interventional cardiology, specialists use several types of mechanical circulatory support devices for patients in cardiogenic shock, especially after an acute coronary syndrome or myocardial infarction. Impella and IABP are two devices inserted percutaneously, typically through the femoral artery, and occasionally through the axillary artery. More Support, Not Necessarily Better Impella, a temporary rotary heart pump, provides stronger circulatory support than the traditional balloon pump, explained Diljon Chahal, MD, a cardiologist at University of Maryland Medical Center in Baltimore. However, he said, the Impella catheter is significantly larger than the IABP catheter, which can increase the risk of bleeding, vascular injury, and infection. "There has been ongoing controversy over which device may be better for patients in cardiogenic shock. Several prior studies, including the IMPRESS and ISAR-SHOCK trials, showed no significant difference in 30-day mortality between Impella and IABP in this setting," he pointed out. "While Impella does provide greater immediate hemodynamic support, this new propensity-matched analysis shows that greater support does not necessarily translate into better outcomes," he said. "The findings of higher 30-day mortality, more cardiac arrests, and higher rates of sepsis suggest that device-related complications may offset the intended benefits, particularly when used broadly without careful patient selection." This current analysis "is thought-provoking and reinforces the need for more randomized trials with longer-term follow-up," he said. "Until we have stronger prospective data, mechanical support decisions must be individualized, carefully balancing risks and benefits, rather than assuming that more support is always better. Although this study is valuable, the jury is still out on whether Impella offers a true survival advantage over IABP in cardiogenic shock."
Hans India
27-04-2025
- Health
- Hans India
Advanced methods transforming coronary artery treatments: Sr cardiologist
Tirupati: Senior consultant interventional cardiologist at Apollo Main hospitals in Chennai Dr Y Vijayachandra Reddy said that highly advanced methods are now available to treat blocks in coronary arteries. Addressing the media in Tirupati on Saturday, Dr Reddy explained that the main cause of artery blockage is the build-up of LDL cholesterol, which can trigger a series of damaging changes in the blood vessels, potentially leading to heart attacks or sudden cardiac death. He emphasized that while gradual blockage can cause angina and chronic heart conditions, the sudden rupture of plaques can result in acute heart attacks within minutes, necessitating urgent treatment. Coronary angiography (CAG), along with ECG and echocardiography, helps in diagnosing the severity of blocks. He underlined the importance of preventive measures to avoid severe risks. Treatments range from medications and lifestyle changes for mild cases to advanced coronary angioplasty and stenting (PCI) or bypass surgery (CABG) for severe cases. Thanks to major advances in stent technology, guidewires, imaging modalities like IVUS and OCT, and support devices like Impella pumps, even complex blockages can now often be treated successfully with minimally invasive angioplasty, reducing the need for open-heart surgery. Highlighting innovations such as drug-eluting stents, shockwave lithotripsy, robotic PCI, and ultra-low contrast procedures, Dr Reddy called the current era a 'golden age' for coronary interventions, offering safer, more effective options for patients.
Yahoo
26-02-2025
- Health
- Yahoo
Husband's quick CPR saves 42 y.o. mom after ‘massive heart attack': Healthy You
WICHITA FALLS (KFDX/KJTL) — When it comes to cardiac health, things like heart attacks and cardiac arrest can happen without warning. December 10 started out like any other day for Michelle Gresham. 'I was swimming at the Y the Saturday before. I had a Christmas party at work the Saturday before,' Gresham said. 'I had no signs or symptoms at all.' But that night, Gresham felt nauseous, passing out. For the 42-year-old mother, everything changed. 'I was just kind of in shock about being 42 years old and just having a massive heart attack. It's unheard of,' Gresham said. 'The only thing they could tell me was smoking, so don't smoke.' Her husband leaped into action with CPR, getting Gresham to United Regional, where Cath Lab Director and Interventional Cardiologist Dr. Venkat Thota says it was all hands on deck. 'There's no words to describe knowing that your husband saved your life,' Gresham said. 'When the patient calls 911, the EMT knows how to contact a, how to send the EKG from the field,' Thota explained. 'The ER physician contacts the cath lab; we come to the ER within 20 to 25 minutes because there is a window of opportunity to open the vessel.' In that window, Gresham suffered cardiogenic shock, prompting Thota to utilize a small catheter called the Impella. 'We are fortunate we have the latest technology in United Regional,' Thota said. 'We use this pump to do the angioplasty to open the blood vessels. Literally, this pump will always help in the cardiogenic shock.' 'If I had to be sent somewhere else, I wouldn't be here,' Gresham said. 'So thank goodness they have some devices like the Impella.' Gresham added that not only are the devices top-notch, but the care is, too. 'One of the nurses that took care of me during the two surgeries was Heather,' Gresham said. 'She came to see me in recovery, and my family was in tears just because of the care that she had provided for me.' Thanks to her husband's quick thinking and the team's empathy… 'Get your CPR license,' she said. 'Know how to do CPR. It's imperative.' …Gresham is getting stronger day by day. According to Thota, the most common symptoms to look out for are excruciating chest pains and a sudden onset of shortness of breath, especially in women. In cases like Gresham's, however, acting fast with CPR and dialing 911 can be lifesaving. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
