Safety and efficacy of percutaneous cannulation for extracorporeal membrane oxygenation in high-risk patients undergoing percutaneous coronary intervention
10.3969/j.issn.1004-8812.2025.03.002
- VernacularTitle:经皮穿刺插管建立体外膜肺氧合应用于高危经皮冠状动脉介入治疗患者的安全性和有效性
- Author:
Jun-jie XU
1
;
Cheng-yi XU
;
Cheng-wei LIU
;
Dan SONG
;
Hua YAN
;
Xiao-jing MA
Author Information
1. 武汉科技大学附属武汉亚洲心脏病医院心内科,湖北武汉 430022;武汉科技大学医学部医学院,湖北武汉 430062
- Publication Type:Journal Article
- Keywords:
High-risk percutaneous coronary intervention;
Veno-arterial extracorporeal membrane oxygenation;
Mechanical circulatory support;
Complications
- From:
Chinese Journal of Interventional Cardiology
2025;33(3):128-134
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the safety of establishing the veno-arterial extracorporeal membrane oxygenation(VA-ECMO)pipeline through percutaneous puncture and the effectiveness of high-risk percutaneous coronary intervention(HR-PCI)under VA-ECMO assistance.Methods In this single-center retrospective study,patients who underwent HR-PCI assisted by VA-ECMO at Wuhan Asian Heart Hospital from December 2022 to December 2023 were included.The primary endpoint was the safety of establishing the VA-ECMO pipeline through percutaneous puncture,mainly characterized by extracorporeal membrane oxygenation(ECMO)-related complications,including severe bleeding/hematoma at the wound,arteriovenous fistula,pseudoaneurysm,peripheral arterial dissection,etc.The secondary endpoint was the effectiveness of HR-PCI under VA-ECMO assistance,defined as major adverse cardiovascular and cerebrovascular events(MACCE)at 6-month follow-up,including the composite events of all-cause death,non-fatal myocardial infarction,repeat revascularization,and ischemic stroke.Results Among the 189 patients included in the study,15(7.9％)had severe bleeding/hematoma at the puncture wound caused by VA-ECMO,8(4.2％)had wound infection,1(0.5％)had arteriovenous fistula,4(2.1％)had pseudoaneurysm,3(1.6％)had peripheral arterial dissection,8(4.2％)had systemic embolism,8(4.2％)had acute kidney injury,3(1.6％)had acute neurological injury,and 1(0.5％)died.percutaneous coronary intervention(PCI)was successful in 182 cases(96.3％),and a total of 36 cases(19.0％)had PCI-related complications.164 patients completed 6-month follow-up,among which 4(2.4％)had all-cause death,11(6.7％)had non-fatal myocardial infarction,11(6.7％)had unplanned repeat revascularization,and 2(1.2％)had the composite event of ischemic stroke.Conclusions Ultrasound-guided percutaneous puncture for establishing the VA-ECMO pipeline has high safety,and HR-PCI patients assisted by VA-ECMO have good short-term effects.
