Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-087
Protected PCI for High Risk and Cardiogenic Shock With IABP - A Retrospective Single Centered Observational Study
By Rohit Mody
Presenter
Rohit Mody
Authors
Rohit Mody1
Affiliation
Mody Harvard Cardiac Institute & Research Centre, India1
View Study Report
TCTAP A-087
Cardiogenic Shock
Protected PCI for High Risk and Cardiogenic Shock With IABP - A Retrospective Single Centered Observational Study
Rohit Mody1
Mody Harvard Cardiac Institute & Research Centre, India1
Background
Between June 2020 and August 2024, 225 patients with cardiogenic shock were treated with DES implantation. This non-randomized, single-center, observational, retrospective study divided patients into two categories:
- Protected PCI for high-risk patients with IABP support: 56 patients
- Primary PCI for cardiogenic shock in STEMI supported by IABP: 169 patients
Methods
- Protected PCI for high-risk patients with IABP support: 13 high-risk CAD patients with IABP-supported PCI targeting culprit vessels. IVUS was used in 80% of cases.
- Culprit Vessel Distribution: LAD 65%, RCA 20%, LCX 15%
- LVEF: <25%, poor hemodynamics
- Syntax Score: 33 ± 8
- Other Characteristics: 4 with calcified disease, 4 with LM disease, 1 stabilized with CRT-D, 3 with TVD and diffuse lesions, and 2 with multiple CTOs.
- Primary PCI for Cardiogenic Shock in STEMI: Patients in cardiogenic shock underwent angiography and PCI within 72 hours if in the window period, with IABP support.
- Culprit Vessel Distribution: LAD 55%, RCA 25%, LCX 20%
- LVEF: 30% ± 12%
- Syntax Score: 26 ± 8
- SCAI Classification: Stage C or above in 60% of patients
- Peripheral Disease: 40%
Results
- Protected PCI for high-risk patients:
- Successful PCI in 100% of patients with 96% clinical success. No minor dissections, coronary perforations, or abrupt closures.
- In-hospital MACE occurred in 23% (6 TVR, 3 MI, 2 deaths at 30-day follow-up).
- Primary PCI for Cardiogenic Shock in STEMI:
- Successful PCI in 99% with angiographic success in 100% and clinical success in 91%. 18 patients had slow flow, managed with vasodilators.
- Secondary endpoints included 30% mortality (132 patients), 8.16% reinfarction, 1.7% stent thrombosis, 1.5% stroke, and 9.5% bleeding.
Conclusion
- Hemodynamically unstable patients in Class 4 benefit from protected PCI with IABP when Impella is unavailable.
- IVUS imaging aids in calcium characterization and modification.
- Despite negative SHOCK 2 trial results, IABP proves useful in clinical practice, especially in resource-constrained settings like India, and this study could generate hypotheses for further research.