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Latest PCI Guidelines Recommend IABP—Are You Using It Correctly?
2025-07-18
Cardiovascular diseases have consistently been a leading cause of death worldwide. With the improvement in living standards and changes in lifestyle, the prevalence and mortality rates of cardiovascular diseases in China continue to rise. Among them, acute coronary syndrome (ACS), characterized by its sudden onset and poor prognosis, stands out as one of the most fatal conditions in cardiovascular emergencies.
A Race Against Time: Acute Coronary Syndrome
It is well known that the human body’s blood circulation relies on the regular beating of the heart, which in turn depends on the myocardium. The contraction and relaxation of the myocardium require a continuous blood supply from the coronary arteries. If the coronary arteries become narrowed or completely blocked due to blood clots, plaque buildup, or other reasons, myocardial cells can undergo irreversible necrosis within a short period due to ischemia and hypoxia. This pathological process manifests as acute coronary syndrome, with typical clinical symptoms including persistent chest pain and tightness.
ACS is an extremely urgent condition—the longer the coronary artery remains blocked, the more myocardial tissue dies, causing the heart to lose its normal contractile strength. At any moment, heart failure, malignant arrhythmias, or even sudden cardiac death may occur. Data show that without timely treatment, the average mortality rate for such patients is around 15%, whereas with prompt and aggressive intervention, it can be reduced to 2%-3%.
Treatment for ACS primarily involves medication and interventional therapy to restore blood flow. For high-risk patients with left main disease, severe multivessel disease, or significant left ventricular dysfunction, the risk of hemodynamic collapse during percutaneous coronary intervention (PCI) increases significantly. In such cases, the use of an intra-aortic balloon pump (IABP) becomes critical to ensuring procedural success.
IABP: Safeguarding PCI – Strongly Recommended by Latest Guidelines
IABP is a mechanical circulatory support device widely used for hemodynamic stabilization in critically ill cardiac patients. Its mechanism involves inserting a balloon catheter into the patient’s descending aorta. An external console, based on continuous monitoring of ECG and arterial pressure signals, inflates and deflates the balloon in sync with the aortic valve’s closing and opening. This action enhances cardiac output, improves blood perfusion, and reduces cardiac workload.
During PCI, IABP increases coronary perfusion, maintains tissue and organ blood flow, optimizes myocardial oxygen supply-demand balance, and reduces cardiac afterload, thereby lowering the risk of intraoperative hemodynamic collapse. It also improves procedural success rates, shortens ICU stays, and enhances clinical outcomes.
A single-center retrospective study found that prophylactic IABP placement in high-risk PCI patients significantly reduced mortality and major complications.
The latest Guidelines for percutaneous coronary intervention (2025) explicitly recommend the use of IABP during PCI. For instance, mechanical circulatory support should be routinely employed in extremely high-risk patients, such as those with cardiogenic shock, decompensated heart failure, hemodynamic instability, severe arrhythmias, or a history of cardiopulmonary resuscitation.
In summary, thanks to its proven efficacy, ease of use, cost-effectiveness, and low complication rates, IABP has been widely adopted worldwide and plays a vital role in the treatment of PCI patients.
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