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Posts Tagged ‘no role for prophylactic iabp’

IABP is thought to be the  savior   when  PCI is done in severely compromised left ventricle and  in other  high risk angioplasties. Without verifying the facts,   routine use of this device became rampant  in cath labs around  the world in the last decade .

Everyone strongly believed , IABP  plays a major role in sustaining coronary  perfusion  during complex PCIs.  Then  the  favorable experience  started  pouring in,  from many cath labs  without IABP  support .   Common  sense struck us ,  and some one asked this question .

 

Should we routinely insert IABP in all  cases of high risk PCI. ?

The  study , published in  JAMA 2010  convincingly  answers  this  question


Can you do a high risk PCI without IABP back up facility ?

In academic sense “No” .

IABP service is not available in many cath labs in India for various reasons .But it does  not  become a contraindication to attempt PCI on  them .At least , we should have  facility to shift the patient  to a nearby advanced cardiac care centre  in case the need arises.

Final message

In plain language (Politeness removed !)  routine  prophylactic  IABP is not only useless ,  it could also  carry a  danger of access site ,  procedure  , expertise (Lack of  it ! ) related  hazards. Remember the Swan Ganz story !

http://jama.ama-assn.org/cgi/content/abstract/304/8/867

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