CORONARY ARTERY STENTING UNDER ECMO SUPPORT: A CASE SERIES DESCRIPTION
Objective: The use of Veno-Arterial Extracorporeal Membrane Oxygenation (VA-ECMO) is a potentially life-saving strategy for patients with refractory cardiogenic shock (CS) secondary to ST-segment elevation myocardial infarction (STEMI)for whom standard therapy is ineffective. Data on the implementation of this method are scarce in the Republic of Kazakhstan (RK).
Aim of the Study To evaluate the feasibility and initial clinical outcomes of emergency percutaneous coronary intervention (PCI) supported by VA-ECMO under a unified protocol in patients with refractory cardiogenic shock in the Republic of Kazakhstan.
Methods A retrospective, single-center study was conducted, including a series of six consecutive patients with refractory CS due to STEMI who underwent emergency coronary artery stenting at the Pavlodar Regional Cardiology Center during the period from October 2024 to September 2025. PCI was performed with active peripheral VA-ECMO support via a femoral approach. The primary endpoint was survival to hospital discharge, and the secondary endpoint was the frequency of major complications.
Results The mean age of the patients was 71.3 years (men — 83.3%). Multivessel coronary artery disease was recorded in 100% of patients. The PCI procedure was technically successful in all 6 cases, achieving TIMI 3 flow. The mean duration of ECMO support during the intervention was 56 minutes (30–90 minutes). Hospital survival was 83.3%(5 out of 6 patients were discharged in satisfactory condition). Among discharged patients, 30- and 90-day survival was 100%. A complication in the form of femoral artery dissection was recorded in 1 patient (16.7%).
Conclusions The application of a unified perioperative management protocol allows for the successful performance of emergency PCI with VA-ECMO support in patients with refractory cardiogenic shock. The method is technically feasible and provides a high level of early survival comparable to international data, confirming its potential as a life-saving option.
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Clinical case
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Antikeev A.M., Ordabayev E.T., Abiltayev A.M., Antikeyev D.A., Abiltayeva A.A., Tleuova A.K., Izguttinov D.E. Coronary Artery Stenting Under ECMO Support: A Case Series Description // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (6), pp. 251-257. doi 10.34689/SH.2025.27.6.028Related publications:
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