{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:14:09Z","timestamp":1788156849437,"version":"build-2803163510"},"reference-count":7,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"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":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Patients with cardiogenic shock, low\u2010flow, low\u2010gradient aortic stenosis, and multivessel coronary artery disease who are ineligible for surgery present a major therapeutic challenge. Percutaneous mechanical circulatory support may facilitate revascularization in this high\u2010risk population. A 69\u2010year\u2010old man presented after a mechanical fall and was found to have non\u2013ST\u2010elevation myocardial infarction, acute decompensated heart failure, low\u2010gradient aortic stenosis, and multivessel coronary artery disease. Echocardiography showed a left ventricular ejection fraction (LVEF) of 25%\u201330% with mild left ventricular dilation and mildly reduced right ventricular systolic function. Laboratory testing demonstrated elevated troponin, markedly elevated B\u2010type natriuretic peptide, and acute kidney injury. Chest radiography revealed bilateral pleural effusions and mild atelectasis. Surgical revascularization was not pursued, as the patient was considered at prohibitive operative risk by cardiothoracic surgery. The patient developed cardiogenic shock requiring Impella 5.5 support and subsequently underwent Impella\u2010assisted high\u2010risk PCI to the left anterior descending artery. He was successfully weaned from mechanical support, renal function recovered, and guideline\u2010directed medical therapy was optimized. He was discharged with a wearable cardioverter\u2010defibrillator and planned repeat echocardiography. This case highlights the role of percutaneous mechanical circulatory support in enabling high\u2010risk PCI in patients with cardiogenic shock, pseudo\u2010severe aortic stenosis, and multivessel coronary artery disease when surgical options are not feasible.<\/jats:p>","DOI":"10.1002\/ccr3.73273","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:55:06Z","timestamp":1785473706000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impella\u2010Assisted High\u2010Risk Percutaneous Coronary Intervention in Cardiogenic Shock With Low\u2010Flow, Low\u2010Gradient Aortic Stenosis and Multivessel Coronary Artery Disease: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4073-8409","authenticated-orcid":false,"given":"Douni","family":"Roger","sequence":"first","affiliation":[{"name":"University of Michigan\/Sparrow Hospital  Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waleed","family":"Shaker","sequence":"additional","affiliation":[{"name":"University of Michigan\/Sparrow Hospital  Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zan","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"University of Michigan\/Sparrow Hospital  Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Abela","sequence":"additional","affiliation":[{"name":"University of Michigan\/Sparrow Hospital  Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12080"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.07.065"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.03.036"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz363"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872619887120"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.25270\/jic\/25.00250"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.repc.2021.11.003"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73273","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73273","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73273","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:22:06Z","timestamp":1788153726000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":7,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/ccr3.73273"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73273","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]},"assertion":[{"value":"2026-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73273"}}