Complete Revascularization, Protected PCI

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



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