{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T02:12:06Z","timestamp":1789006326105,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients undergoing complex high\u2010risk percutaneous coronary interventions (CHIP) are prone to hemodynamic instability, and the optimal mechanical circulatory support (MCS) strategy for this population remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This systematic review and network meta\u2010analysis aimed to compare the short\u2010term safety and efficacy of various MCS strategies in CHIP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Web of Science, Embase, and the Cochrane Library for studies comparing different MCS strategies in CHIP patients with short\u2010term endpoints. The primary efficacy outcome was in\u2010hospital or 30\u2010day mortality. Safety outcomes included MCS\u2010related complications, specifically bleeding and stroke. The MCS strategies evaluated were intra\u2010aortic balloon pump (IABP), veno\u2010arterial extracorporeal membrane oxygenation (VA\u2010ECMO), IMPELLA, VA\u2010ECMO\u2009+\u2009IABP, and VA\u2010ECMO\u2009+\u2009IMPELLA (ECPELLA). A random\u2010effects Bayesian network meta\u2010analysis was performed, integrating both direct and indirect comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve studies involving a total of 75,274 patients were included. Both IABP (OR: 0.33; 95% CI: 0.13\u20130.91) and IMPELLA (OR: 0.44; 95% CI: 0.21\u20130.96) were associated with significantly lower short\u2010term mortality compared to VA\u2010ECMO. No significant differences were observed among other strategies. Rank probability analysis suggested that IABP had the highest probability of being the most effective strategy for reducing short\u2010term mortality. Regarding safety outcomes, IABP was associated with a significantly lower bleeding risk compared to VA\u2010ECMO (OR: 0.18; 95% CI: 0.04\u20130.82), VA\u2010ECMO\u2009+\u2009IABP (OR: 0.18; 95% CI: 0.03\u20130.87), ECPELLA (OR: 0.12; 95% CI: 0.02\u20130.70), and IMPELLA (OR: 0.21; 95% CI: 0.05\u20130.75), with no significant difference in stroke risk across strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among available MCS strategies for CHIP patients, IABP appears to be associated with improved short\u2010term survival and a lower risk of bleeding, without an increased risk of stroke. These findings support IABP as a potentially preferable support option, warranting further validation in prospective clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31678","type":"journal-article","created":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T00:28:58Z","timestamp":1749515338000},"page":"1263-1272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Effectiveness of Mechanical Circulatory Support Devices in Patients Undergoing Complex High\u2010Risk Percutaneous Coronary Interventions (CHIP): A Systematic Review and Network Meta\u2010Analysis"],"prefix":"10.1002","volume":"106","author":[{"given":"Haonan","family":"Xu","sequence":"first","affiliation":[{"name":"Tianjin Key Laboratory of Ionic\u2010Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxin","family":"Guo","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Ionic\u2010Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar Hou In","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Clinical Pharmacology and Therapeutics, School of Clinical Medicine, Li Ka Shing Faculty of Medicine University of Hong Kong Hong Kong China"},{"name":"Diabetes Research Unit Cardiovascular Analytics Group, Power Health Limited Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Tse","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Ionic\u2010Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin China"},{"name":"School of Nursing and Health Studies Hong Kong Metropolitan University Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangping","family":"Li","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Ionic\u2010Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0482-0738","authenticated-orcid":false,"given":"Tong","family":"Liu","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Ionic\u2010Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9392-1583","authenticated-orcid":false,"given":"Huaying","family":"Fu","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Ionic\u2010Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology The Second Hospital of Tianjin Medical University Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab892"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.01.025"},{"key":"e_1_2_10_5_1","article-title":"Prophylactic Impella CP Versus VA\u2010ECMO in Patients Undergoing Complex High\u2010Risk Indicated PCI","volume":"2022","author":"Buijs D. 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