Extracorporeal membrane oxygenation in patients with acute coronary syndrome during high-risk percutaneous coronary intervention

Abstract

Background Percutaneous coronary intervention (PCI) is feasible for patients with complex coronary atherosclerotic disease in coronary revascularization. The safety and feasibility of Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for circulatory support in patients with acute coronary syndrome (ACS) during high-risk PCI remain unclear. Methods This single-center retrospective study, 41patients with ACS who received VA-ECMO circulation-assisted PCI in Lanzhou University Second Hospital from January 2021 to September 2022. General clinical data, laboratory test results, short-term outcome, postoperative complications of patients were collected and analyzed. Results Among 41 patients, only one failed stent implantation due to severe tortuous vessels, 41 patients were successfully performed PCI, and no patient died during the operation. 12 (29.3%) patients occurred postoperative complications included postoperative infection occurred in 6 (14.6%) patients, 8 (19.1%) patients occurred hypotension, 1 (2.4%) patient occurred cerebral hemorrhage, 1 (2.4%) patient happened death due to retroperitoneal hematoma combined with acute heart failure and cardiogenic shock. Conclusion The PCI in complex and high-risk coronary artery lesions with VA-ECMO support is safe and feasible. The benefits of PCI with ECMO need to confirm by larger sample and randomized controlled trials in the future.