PCI complications: Hemodynamic Support for Complex PCI

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Hemodynamic Support for Complex PC

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Anahita Deylamsalehi, M.D.[2]



Rapid hemodynamic deterioration and death during PCI can occur due to hypotension, decompensated heart failure, shock, or arrhythmias.[1][2][3]


Usage of hemodynamic support devices can be helpful in specific circumstances nevertheless, its routine usage is not recommended to reduce cardiovascular events.[2][3]

Hemodynamic Support Devices

2021 ACA Revascularization Guideline

Class 2b Recommendation, Level of Evidence: B-R [1]
Using an appropriate hemodynamic support device in the elective settings and among selected patients is reasonable to prevent hemodynamic compromise during PCI.


  1. 1.0 1.1 1.2 1.3 Writing Committee Members. Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM; et al. (2022). "2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". J Am Coll Cardiol. 79 (2): e21–e129. doi:10.1016/j.jacc.2021.09.006. PMID 34895950 Check |pmid= value (help).
  2. 2.0 2.1 Perera D, Stables R, Thomas M, Booth J, Pitt M, Blackman D; et al. (2010). "Elective intra-aortic balloon counterpulsation during high-risk percutaneous coronary intervention: a randomized controlled trial". JAMA. 304 (8): 867–74. doi:10.1001/jama.2010.1190. PMID 20736470.
  3. 3.0 3.1 O'Neill WW, Kleiman NS, Moses J, Henriques JP, Dixon S, Massaro J; et al. (2012). "A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study". Circulation. 126 (14): 1717–27. doi:10.1161/CIRCULATIONAHA.112.098194. PMID 22935569.