Clinical outcomes of extracorporeal membrane oxygenation in complex high-risk and indicated patients undergoing PCI

Hu Conglong; Yin Liyi; Huang Mingjun; Cao Yan; Han Xiaotong

doi:10.3969/j.issn.1002-1949.2024.11.004

Abstract：Objective To evaluate the clinical outcomes of extracorporeal membrane oxygenation(ECMO)support in complex high-risk and indicated patients(CHIPs)undergoing percutaneous coronary intervention(PCI).Methods A retrospective analysis was conducted on 52 CHIPs who underwent PCI.Patients were divided into two groups based on the timing of ECMO support:a preoperative support group(n=24)and an intraoperative support group(n=28).Baseline characteristics,preoperative conditions,in-hospital mortality rate,coronary angiography results,coronary scores and the incidence of complications were compared between the two groups.Results The in-hospital mortality rate in the preoperative support group was 12.5％,which was significantly lower than the 64.3％in the intraoperative support group(P＜0.001).In the preoperative support group,5 patients(20.8％)accepted concomitant intra-aortic balloon pump(IABP)compared to 14 patients(50％)in the intraoperative group.Statistically significant differences were found in terms of leukocyte count,high-density lipoprotein levels,intraoperative lactate peak,and overall mortality rate between the two groups(all P＜0.05),and the preoperative support group demonstrated better outcomes.Furthermore,the incidence of neurological,cardiac,and limb complications was significantly lower in the preoperative support group(all P＜0.05).However,there were no statistical differences in coronary scores,coronary angiography results,extent of coronary lesions,ECMO setup time,duration of ECMO support and PCI procedure time between the two groups(all P＞0.05).Conclusions For CHIPs undergoing PCI,preoperative ECMO support effectively reduces the mortality rate and ECMO-related complications.This strategy provides an optimized treatment approach for CHIPs.