{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:12:25Z","timestamp":1779351145014,"version":"3.51.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":875,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020297","name":"Abiomed","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020297","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020297","name":"Abiomed","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020297","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Coronary artery disease (CAD) and its complications remain the main cause of morbidity and mortality worldwide. Patients with extensive CAD and multiple comorbidities who require complex, high-risk percutaneous coronary intervention (HR-PCI) are at risk of haemodynamic instability and may require short-term mechanical circulatory support (MCS) during the procedure to maintain sufficient perfusion and prevent ischaemia. Impella is a microaxial continuous blood flow pump used for percutaneous support of the left ventricle in patients undergoing HR-PCI. Data from randomized controlled trials and registries suggested an advantage for Impella devices in patients undergoing HR-PCI, compared with other types of MCS. As a thorough understanding of the benefits and drawbacks of the Impella technology is crucial for patient outcomes, we provide a technological overview of Impella and share our experiences gathered during the implementation of institutional Impella programmes in Poland as a roadmap of selection and periprocedural care for patients treated with Impella in the setting of HR-PCI. We propose 10 steps for implementation of an institutional Impella programme for HR-PCI, including (i) dedicated staff training; (ii) standard operating procedure and troubleshooting algorithms prior to the first intervention; (iii) patient selection by the multidisciplinary Heart Team; (iv) patient preparation using multimodality imaging; (v) procedure planning in terms of large-bore access, equipment, and complete revascularization; (vi) starting with HR-PCI support; (vii) starting with femoral artery access in a patient without extensive peripheral artery disease; (viii) multidisciplinary care after the procedure; (ix) haemodynamic and laboratory monitoring to ensure immediate diagnosis of access-site complications, bleeding, haemolysis, acute kidney injury, and infections; and (x) careful revision of every HR-PCI case with the team.<\/jats:p>","DOI":"10.1002\/ehf2.14397","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T06:01:13Z","timestamp":1687586473000},"page":"2200-2213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Roadmap Towards an Institutional Impella Programme for High-Risk Coronary Interventions"],"prefix":"10.1093","volume":"10","author":[{"given":"Arkadiusz","family":"Pietrasik","sequence":"first","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw , Warsaw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5083-7587","authenticated-orcid":false,"given":"Aleksandra","family":"G\u0105secka","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw , Warsaw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4361-6609","authenticated-orcid":false,"given":"Karolina","family":"Jasi\u0144ska-Gniadzik","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw , Warsaw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Szwed","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw , Warsaw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marek","family":"Grygier","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Poznan University of Medical Sciences , Pozna\u0144 ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Paw\u0142owski","sequence":"additional","affiliation":[{"name":"Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior and Administration , Warsaw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerzy","family":"Sacha","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital in Opole , Opole ,","place":["Poland"]},{"name":"Faculty of Physical Education and Physiotherapy, Opole University of Technology , Opole ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janusz","family":"Kochman","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw , Warsaw ,","place":["Poland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"2026012114092272000_ehf214397-bib-0001","doi-asserted-by":"crossref","first-page":"256","DOI":"10.21037\/atm.2016.06.33","article-title":"Epidemiology of coronary 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patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study","volume":"126","author":"O'Neill","year":"2012","journal-title":"Circulation"},{"key":"2026012114092272000_ehf214397-bib-0005","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1016\/j.jacc.2008.05.065","article-title":"A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction","volume":"52","author":"Seyfarth","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2026012114092272000_ehf214397-bib-0006","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1001\/jamainternmed.2022.2735","article-title":"Clinical outcomes and cost associated with an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump in patients presenting with acute myocardial infarction complicated by cardiogenic 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