Percutaneous left ventricular assist devices for high-risk percutaneous coronary intervention

Although coronary artery bypass grafting remains an important therapeutic option for patients with complex coronary artery disease, percutaneous coronary intervention strategies have become an established alternative. Nevertheless, treatment options for surgery-ineligible patients with complex coronary artery disease used to be limited, especially in patients with a reduced left ventricular function. Those patients are at high risk of profound hypotension and mortality, which may be adequately prevented by prophylactic placement of a percutaneous mechanical assist device. Although many devices have been developed and randomized evidence is still pending, the Impella LP2.5 device (Abiomed-Impella CardioSystems GmbH, Aachen, Germany) seems to be promising as it is easily applicable, carries a low complication rate and provides adequate circulatory support.