Clinical Relevance of Revascularization Extent in Protected PCI: Insight From Italian Studies

Francesco Burzotta, MD, discusses the clinical impact of revascularization extent in Protected PCI. Notably, he highlights results from the large Revascularization Extent in Impella® Italian Registry (R-IMP-IT) which include:

• More extensive revascularization achieved during Impella Protected PCI (revascularization index (RI) ≥0.67) is associated with significant reduction in the primary endpoint (all cause death, nonfatal MI, and nonfatal stroke at 1-year follow-up) for the entire study population as well as in the high-risk PCI subgroup of patients
• Significant reduction in the secondary endpoint of all cause death in the more extensive revascularization group for the entire study population
• Better clinical outcomes in both cardiogenic shock and high-risk PCI subgroups with more complete revascularization
• Operators performing Impella-Protected PCI may aim to improve late clinical outcomes by achieving more extensive revascularization
• Because better outcomes were associated with an RI ≥0.67, operators can use their clinical judgment in determining which lesions to treat since not all lesions need to be treated to achieve the clinical advantages