Thrombus Aspiration and Balloon Pumps in Cardiogenic Shock – What's the Bottom Line? - Dr. Yousif Ahmad

152 views

Summary


Yousif Ahmad discusses adjunctive treatments for ACS in the catheter laboratory such as thrombus aspiration and balloon pumps (IABP)

  • When and when not to use
  • Real benefits and justification for thrombus aspiration and IABP use following clinical trials results

Thrombus aspiration

  • Theoretical advantages of thrombus aspiration
    • Reduce Embolisation
    • Reduce thrombus burden
    • Reduce no-reflow
    • Visualise anatomy better
    • Facilitate direct stenting
    • Facilitate shorter stents
  • TOTAL - No mortality benefit.  But, numerically small, but significantly small increase in stroke with thrombus aspiration.
  • Class III recommendation in USA for routine use of aspiration.  This suggests that it is of no certain benefit, and maybe harmful.  

Intra-arterial balloon pump (IABP)

  • Theoretical benefits in cardiogenic shock
    • Decrease afterload
    • Increase diastolic coronary perfusion
    • Augment blood pressure
  • Previously considered class I indication for treatment of shock, now (2016) Class III indication.  
  • No evidence of benefit in randomised trials
  • No evidence of benefit in observational trials


Simple Education
1,191 videos

Simple Education, is a leading provider of coronary physiology and intracoronary imaging courses to aid treatment of complex coronary artery disease.

Join the conversation

to comment