Prophylactic Venoarterial Extracorporeal Membrane Oxygenation (VA-ECMO) During Complex High-Risk Percutaneous Coronary Intervention (PCI): A Randomized Controlled Trial
Authors' conclusion
In this single-center study of patients undergoing elective PCI of complex high-risk coronary lesions, prophylactic VA-ECMO was associated with lower rates of life-threatening complications and larger reduction in SYNTAX scores. Larger studies are needed to further define optimal management strategies in high-risk complex PCI.
Study context
- Population
- Patients with complex high-risk coronary lesions (SYNTAX score ≥33) who declined coronary artery bypass grafting, undergoing elective PCIwomen: 14.3%, enrolled between June 2021 and August 2023
- Participants
- 70 patients
- Comparison
- Prophylactic VA-ECMO vs no prophylactic VA-ECMO during elective PCI
- VA-ECMOn = 34
- Controln = 36
- Primary endpoint
- Rate of complications during PCI (life-threatening complications) and SYNTAX score reduction post-PCI
Methodological detailssingle-center
- Single-center
Primary result
As reported in the abstract
Life-threatening complications
| Outcome | VA-ECMO | Control |
|---|---|---|
| Absolute reduction in SYNTAX score | 27.2 [24.5-35.0] | 22.5 [11.5-32.8] |
Further findings
| Outcome | VA-ECMO | Control |
|---|---|---|
| Baseline SYNTAX score · pre-PCI | 37.8 [34.5-44.0] | 35.8 [33.2-40.8] |
| Emergency VA-ECMO | — not stated in the abstract | 19.4% |
— not stated in the abstract
- Baseline SYNTAX score: similar, P = 0.11
Original publication
Prophylactic VA-ECMO During Complex High-Risk PCI: A Randomized Controlled Trial. JACC Adv. Published 22 August 2025. doi:10.
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