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Updated: Jul 8, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Lower AKI Risk and Higher Survival With Microaxial Flow Pump Support During Elective PCI: A Propensity Score-Matched

Elric Zweck1, Andrew Shaw2, Amin Polzin1

  • 1Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|July 7, 2026
PubMed
Summary

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Micro-axial flow pump (mAFP) support during high-risk percutaneous coronary intervention (PCI) is linked to reduced acute kidney injury (AKI) and improved survival compared to intraaortic balloon pump (IABP). This finding offers valuable insights for optimizing patient outcomes in PCI procedures.

Area of Science:

  • Cardiology
  • Nephrology
  • Medical Devices

Background:

  • Acute kidney injury (AKI) is a significant complication following percutaneous coronary intervention (PCI), leading to poorer patient outcomes.
  • Previous research suggested potential nephroprotective benefits of micro-axial flow pumps (mAFP) during PCI, warranting further investigation.
  • High-risk PCI procedures necessitate effective strategies to mitigate renal complications.

Purpose of the Study:

  • To compare the renal outcomes of high-risk PCI when supported by mAFP versus intraaortic balloon pump (IABP).
  • To evaluate the impact of mAFP and IABP on acute kidney injury (AKI) incidence in patients undergoing high-risk PCI.
  • To assess differences in all-cause mortality and other adverse events between mAFP and IABP support groups.

Main Methods:

Keywords:
acute kidney injuryinterventional cardiologykidney outcomesmechanical circulatory supportrenal replacement therapy

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  • A retrospective analysis of patients undergoing elective, high-risk PCI with mAFP or IABP support between 2017 and 2025 was conducted using the TRUVETA database.
  • Propensity score matching was employed to balance baseline characteristics, including AKI risk, kidney function, and comorbidities, between the mAFP and IABP groups.
  • A total of 4666 patients (2333 per group) were included after propensity score matching, ensuring comparable cohorts for analysis.

Main Results:

  • The incidence of AKI was significantly lower in the mAFP group (18.9%) compared to the IABP group (23.2%) (p < 0.001).
  • All-cause mortality was also reduced in patients supported by mAFP (15.9%) versus IABP (20.7%) (p < 0.001).
  • Rates of bleeding, stroke, and renal replacement therapy (RRT) were comparable between the two support devices, with no interaction observed between baseline kidney function and the reduced AKI risk with mAFP.

Conclusions:

  • The use of mAFP during elective high-risk PCI is associated with a reduced risk of AKI and improved survival rates when compared to IABP support.
  • These findings suggest that mAFP may be a preferred mechanical circulatory support device for optimizing renal outcomes in high-risk PCI patients.
  • The study highlights the importance of device selection in mitigating complications and improving prognoses in complex PCI procedures.