Abstract

ERCUTANEOUS CORONARY INtervention (PCI) in patients with impaired left ventricular function can be associated with significant mortality and morbidity, particularly when a substantial proportion of viable myocardium is subtended by diseased coronary arteries. 1,2uch patients have diminished reserve to withstand the consequences of ischemia or arrhythmias that may occur during PCI and are at risk of entering a spiral of hemodynamic compromise, potentially culminating in cardiogenic shock or death.In these circumstances, vital hemodynamic support can be provided by an intraaortic balloon pump (IABP), which simultaneously augments coronary blood flow and decreases myocardial oxygen demand. 3,4ncreased understanding of the physiological benefits of counterpulsation and evidence of its efficacy in cardiogenic shock 5 have led to an expansion in the indications for IABP use.The Benchmark Registry showed that the most common reason for IABP insertion is to electively support patients who are hemodynamically stable at the outset but perceived to be at high risk of major complications during angiography or PCI.