New LV Assist Device Shows Benefits in High-Risk PCI Patients

Introduced to the U.S. market in 2008 as an upgraded alternative to the intra-arterial balloon pump, the Impella 2.5 showed clear signs of better performance in high-risk patients undergoing percutaneous coronary intervention in a multicenter, randomized trial with 447 patients.

PROTECT II was a prospective, multicenter, randomized, controlled trial of the Impella Recover LP 2.5 system vs. IABP (intra-aortic balloon pump) in patients undergoing nonemergent, high-risk PCI. The trial began in November 2007 at 67 U.S. sites, 4 sites in Canada, and 1 site in the Netherlands. It enrolled patients with either unprotected left main coronary disease and a left ventricular ejection fraction of 35% or less, or patients with triple-vessel coronary disease and an ejection fraction of 30% or less. The primary end point was the 30-day rate of death, MI, stroke, need for repeat revascularization, need for cardiovascular surgery or vascular surgery for limb ischemia, acute renal dysfunction, increased aortic insufficiency, severe hypotension, need for cardiopulmonary resuscitation, ventricular tachycardia, or failure to reopen the target coronaries by PCI. 


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SCAI Releases First Report on Transradial Access for Angioplasty and Stenting

As interventional cardiologists increasingly perform angiography or angioplasty and stent procedures via radial (wrist) access versus femoral (groin or upper leg) access, it will be imperative to develop training and competency guidelines, according to the first report from the Society for Cardiovascular Angiography and Intervention's (SCAI) Transradial Working Group released today at the SCAI 2011 Scientific Sessions and published in Catheterization and Cardiovascular Interventions. The report reviews issues such as patient selection and preparation, artery access, catheter and therapy selection, primary PCI, potential complications and training for intervention cardiologists performing procedures via radial access.

Radial access is quite common around the world, though it still remains relatively unused in the United States. Recent research, including the RIVAL Trial presented at the 2011 American College of Cardiology (ACC) 60th Annual Scientific Sessions, has shown radial access is a safe and effective technique, can increase survival for heart attack patients, and is often preferred by patients over femoral access. However, published guidelines for the procedure and training are not yet available.

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