ABSTRACT
D uring the past decade, several percutaneous support devices for coronary angioplasty have been developed with the aim of improving myocardial tolerance to ischemia, thereby increasing the safety of coronary angioplasty and allowing the expansion of its indications. Thus, supported coronary angioplasty has been applied in patients with high risk conditions such as multivessel disease, unstable angina, impaired left ventricular function and myocardial infarction complicated by cardiogenic shock.1'5 In the event of abrupt vessel closure during coronary angioplasty, mechanical support devices may provide a bridge until reperfusion is established1,4 either by repeated coronary angioplasty or by emergency bypass surgery. The broader application of percutaneous support devices for high risk coronary angioplasty, however, is still limited by their inadequate efficacy or by complications associated with their use.1,5'7
Three main approaches have been chosen for mechanical support o f acutely ischemic myocardium during coronary angioplasty: antegrade methods, whole heart support and retroinfusion of coronary veins (Fig. 14.1).
