151
Views
1
CrossRef citations to date
0
Altmetric
Review

Mechanical circulatory support in cardiogenic shock: a critical appraisal

, &
Pages 443-454 | Received 23 Nov 2021, Accepted 13 May 2022, Published online: 22 May 2022

References

  • Karami M, den Uil CA, Ouweneel DM, et al. Mechanical circulatory support in cardiogenic shock from acute myocardial infarction: impella CP/5.0 versus ECMO. Eur Heart J Acute Cardiovasc Care. 2020;9(2):164–172.
  • Vahdatpour C, Collins D, Goldberg S. Cardiogenic Shock. J Am Heart Assoc. 2019;8(8):1–12.
  • Tehrani BN, Truesdell AG, Psotka MA, et al. A Standardized and Comprehensive Approach to the Management of Cardiogenic Shock. JACC Heart Fail. 2020;8(11):879–891.
  • Thiele H, de Waha-thiele S, Freund A, et al. Management of cardiogenic shock. EuroIntervention. 2021;17(6):451–465.
  • Baran DA, Grines CL, Bailey S, et al. SCAI clinical expert consensus statement on the classification of cardiogenic shock: this document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Societ. Catheterization Cardiovasc Interventions.2019. DOI:https://doi.org/10.1002/ccd.28329.
  • Shah AH, Puri R, Kalra A. Management of cardiogenic shock complicating acute myocardial infarction: a review. Clin Cardiol. 2019;42(4):484–493.
  • Obradovic D, Freund A, Feistritzer HJ, et al. Temporary mechanical circulatory support in cardiogenic shock. Prog Cardiovasc Dis. 2021;69:35–46.
  • McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021. DOI:https://doi.org/10.1093/eurheartj/ehab368.
  • Tehrani BN, Damluji AA, Batchelor WB. Acute myocardial infarction and cardiogenic shock Interventional approach to management in the cardiac catheterization laboratories. Curr Cardiol Rev. 2021;17. DOI:https://doi.org/10.2174/1573403X17666211125090929.
  • Werdan K, Buerke M, Geppert A, et al. Infarction-Related Cardiogenic Shock- Diagnosis, Monitoring and Therapy–A German-Austrian S3 Guideline. Dtsch Arztebl Int. 2021;118(6):88–95.
  • Boeken U, Assmann A, Beckmann A, et al. Extracorporeal Circulation (ECLS/ECMO) for Cardio-circulatory Failure-Summary of the S3 Guideline. Thorac Cardiovasc Surg. 2021;69(6):483–489.
  • Parissis H, Graham V, Lampridis S, et al. IABP: history-evolution-pathophysiology-indications: what we need to know. J Cardiothorac Surg. 2016;11(1). DOI:https://doi.org/10.1186/s13019-016-0513-0
  • Kimman JR, Van Mieghem NM, Endeman H, et al. Mechanical Support in Early Cardiogenic Shock: what Is the Role of Intra-aortic Balloon Counterpulsation? Curr Heart Fail Rep. 2020;17(5):247–260.
  • Kern MJ, Aguirre F, Bach R, et al. Augmentation of coronary blood flow by intra-aortic balloon pumping in patients after coronary angioplasty. Circulation. 1993;87(2):500–511.
  • Bastos MB, Burkhoff D, Maly J, et al. Invasive left ventricle pressure-volume analysis: overview and practical clinical implications. Eur Heart J. 2020;41:1286–1297.
  • Baldetti L, Pagnesi M, Gramegna M, et al. Intra-Aortic Balloon Pumping in Acute Decompensated Heart Failure With Hypoperfusion: from Pathophysiology to Clinical Practice. Circ Heart Fail. 2021;14(11):e008527.
  • Morici N, Marini C, Sacco A, et al. Intra-aortic Balloon Pump for Acute-on-Chronic Heart Failure Complicated by Cardiogenic Shock. J Card Fail. 2021. DOI:https://doi.org/10.1016/J.CARDFAIL.2021.11.009.
  • Prondzinsky R, Lemm H, Swyter M, et al. Intra-aortic balloon counterpulsation in patients with acute myocardial infarction complicated by cardiogenic shock: the prospective, randomized IABP SHOCK Trial for attenuation of multiorgan dysfunction syndrome. Crit Care Med. 2010;38(1):152–160.
  • Baran DA, Visveswaran GK, Seliem A, et al. Differential responses to larger volume intra‐aortic balloon counterpulsation: hemodynamic and clinical outcomes. Catheterization Cardiovasc Interventions. 2018;92(4):703.
  • Fried JA, Nair A, Takeda K, et al. Clinical and hemodynamic effects of intra-aortic balloon pump therapy in chronic heart failure patients with cardiogenic shock. J Heart Lung Transplant. 2018;37(11):1313–1321.
  • Moulopoulos S, Stamatelopoulos S, Petrou P. Intraaortic balloon assistance in intractable cardiogenic shock. Eur Heart J. 1986;7(5):396–403.
  • Anderson RD, Ohman EM, Holmes DR, et al. Use of Intraaortic Balloon Counterpulsation in Patients Presenting with Cardiogenic Shock: observations from the GUSTO-I Study. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries. 1997.
  • Waksman R, Weiss AT, Gotsman MS, et al. Intra-aortic balloon counterpulsation improves survival in cardiogenic shock complicating acute myocardial infarction. Eur Heart J. 1993;14(1):71–74.
  • Thiele H, Schuler G, Neumann FJ, et al. Intraaortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock: design and rationale of the Intraaortic Balloon Pump in Cardiogenic Shock II (IABP-SHOCK II) trial. Am Heart J. 2012;163(6):938–945.
  • Thiele H, Zeymer U, Neumann FJ, et al. Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): fi nal 12 month results of a randomised, open-label trial. Lancet. 2013;382:1638–1645.
  • Thiele H, Zeymer U, Thelemann N, et al. Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial. Circulation. 2019;139(3):395–403.
  • Unverzagt S, Buerke M, de Waha A, et al. Intra-aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock. Cochrane Database Syst Rev. 2015. DOI:https://doi.org/10.1002/14651858.CD007398.pub3.
  • O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. J Am Coll Cardiol. 2013. DOI:https://doi.org/10.1016/j.jacc.2012.11.019.
  • Chera HH, Nagar M, Chang NL, et al. Overview of Impella and mechanical devices in cardiogenic shock. Expert Rev Med Devices. 2018;15(4):293–299.
  • Griffith BP, Anderson MB, Samuels LE, et al. The RECOVER I: a multicenter prospective study of Impella 5.0/LD for postcardiotomy circulatory support. J Thorac Cardiovasc Surg. 2013;145(2):548–554.
  • O’Neill WW, Schreiber T, Wohns DHW, et al. The current use of impella 2.5 in acute myocardial infarction complicated by cardiogenic shock: results from the USpella Registry. J Interv Cardiol. 2014;27(1):1–11.
  • Seyfarth M, Sibbing D, Bauer I, et al. A Randomized Clinical Trial to Evaluate the Safety and Efficacy of a Percutaneous Left Ventricular Assist Device Versus Intra-Aortic Balloon Pumping for Treatment of Cardiogenic Shock Caused by Myocardial Infarction. J Am Coll Cardiol. 2008;52(19):1584–1588.
  • Cubeddu RJ, Lago R, Horvath SA, et al. Use of the Impella 2.5 system alone, after and in combination with an intra-aortic balloon pump in patients with cardiogenic shock: case description and review of the literature. EuroIntervention. 2012;7(12):1453–1460.
  • Ouweneel DM, Eriksen E, Sjauw KD, et al. Percutaneous Mechanical Circulatory Support Versus Intra-Aortic Balloon Pump in Cardiogenic Shock After Acute Myocardial Infarction. J Am Coll Cardiol. 2017. DOI:https://doi.org/10.1016/j.jacc.2016.10.022.
  • Dhruva SS, Ross JS, Mortazavi BJ, et al. Association of Use of an Intravascular Microaxial Left Ventricular Assist Device vs Intra-aortic Balloon Pump with In-Hospital Mortality and Major Bleeding among Patients with Acute Myocardial Infarction Complicated by Cardiogenic Shock. JAMA. 2020. DOI:https://doi.org/10.1001/jama.2020.0254.
  • Schrage B, Ibrahim K, Loehn T, et al. Impella Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock. Circulation. 2019;139(10):1249–1258.
  • Yancy CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2017;70(6):776–803.
  • Thiele H, Lauer B, Hambrecht R, et al. Reversal of cardiogenic shock by percutaneous left atrial-to-femoral arterial bypass assistance. Circulation. 2001;104(24):2917–2922.
  • Smith LV, Peters A, Mazimba S, et al. Outcomes of patients with cardiogenic shock treated with TandemHeart ® percutaneous ventricular assist device: importance of support indication and definitive therapies as determinants of prognosis. Catheterization Cardiovasc Interventions. 2018;92(6):1173–1181.
  • Thiele H, Sick P, Boudriot E, et al. Randomized comparison of intra-aortic balloon support with a percutaneous left ventricular assist device in patients with revascularized acute myocardial infarction complicated by cardiogenic shock. Eur Heart J. 2005;26(13):1276–1283.
  • Burkhoff D, Cohen H, Brunckhorst C, et al. A randomized multicenter clinical study to evaluate the safety and efficacy of the TandemHeart percutaneous ventricular assist device versus conventional therapy with intraaortic balloon pumping for treatment of cardiogenic shock. Am Heart J. 2006;152(3):469.e1–469.e8.
  • Kar B, Gregoric ID, Basra SS, et al. The percutaneous ventricular assist device in severe refractory cardiogenic shock. J Am Coll Cardiol. 2011;57(6):688–696.
  • Wong ASK, Sin SWC. Short-term mechanical circulatory support (intra-aortic balloon pump, Impella, extracorporeal membrane oxygenation, TandemHeart): a review. Ann Transl Med. 2020;8. DOI:https://doi.org/10.21037/atm-20-2171.
  • Chlebowski MM, Baltagi S, Carlson M, et al. Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO. Crit Care. 2020;24(1). DOI:https://doi.org/10.1186/s13054-020-2726-9
  • Combes A, Leprince P, Luyt CE, et al. Outcomes and long-term quality-of-life of patients supported by extracorporeal membrane oxygenation for refractory cardiogenic shock. Crit Care Med. 2008;36(5):1404–1411.
  • Muller G, Flecher E, Lebreton G, et al. The ENCOURAGE mortality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock. Intensive Care Med. 2016;42(3):370–378.
  • Sheu JJ, Tsai TH, Lee FY, et al. Early extracorporeal membrane oxygenator-assisted primary percutaneous coronary intervention improved 30-day clinical outcomes in patients with ST-segment elevation myocardial infarction complicated with profound cardiogenic shock. Crit Care Med. 2010;38(9):1810–1817.
  • Lemor A, Hosseini Dehkordi SH, Basir MB, et al. Impella Versus Extracorporeal Membrane Oxygenation for Acute Myocardial Infarction Cardiogenic Shock. Cardiovasc Revascularization Med. 2020;21(12):1465–1471.
  • Thiele H, Freund A, Gimenez MR, et al. Extracorporeal life support in patients with acute myocardial infarction complicated by cardiogenic shock - Design and rationale of the ECLS-SHOCK trial. Am Heart J. 2021;234:1–11.
  • Banning AS, Adriaenssens T, Berry C, et al. Veno-arterial extracorporeal membrane oxygenation (ECMO) in patients with cardiogenic shock: rationale and design of the randomised, multicentre, open-label EURO SHOCK trial. EuroIntervention. 2021;16(15):E1227–E1236.
  • Balthazar T, Vandenbriele C, Verbrugge FH, et al. Managing Patients With Short-Term Mechanical Circulatory Support: JACC Review Topic of the Week. J Am Coll Cardiol. 2021;77(9):1243–1256.
  • Kunkel KJ, Fuller B, Basir MB. Management of Cardiogenic Shock in Patients with Acute Myocardial Infarction. Interv Cardiol Clin. 2021;10(3):345–357.
  • Lemor A, Ya’qoub L, Basir MB. Mechanical Circulatory Support in Acute Myocardial Infarction and Cardiogenic Shock. Interv Cardiol Clin. 2021;10(2):169–184.
  • Schrage B, Beer BN, Savarese G, et al. Eligibility for mechanical circulatory support devices based on current and past randomised cardiogenic shock trials. European Journal of Heart Failure. 2021;23(11):1942–1951.
  • Berg DD, Barnett CF, Kenigsberg BB, et al. Clinical practice patterns in temporary mechanical circulatory support for shock in the critical care cardiology trials network (ccctn) registry. Circulation. 2019;12(11). DOI:https://doi.org/10.1161/CIRCHEARTFAILURE.119.006635
  • Garan AR, Kanwar M, Thayer KL, et al. Complete Hemodynamic Profiling With Pulmonary Artery Catheters in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality. JACC Heart Fail. 2020;8(11):903–913.
  • Chieffo A, Dudek D, Hassager C, et al. Joint EAPCI/ACVC expert consensus document on percutaneous ventricular assist devices. Eur Heart J Acute Cardiovasc Care. 2021;10(5):570–583.
  • Udesen NJ, Møller JE, Lindholm MG, et al. Rationale and design of DanGer shock: danish-German cardiogenic shock trial. Am Heart J. 2019;214:60–68.
  • Anderson MB, Goldstein J, Milano C, et al. Benefits of a novel percutaneous ventricular assist device for right heart failure: the prospective RECOVER RIGHT study of the Impella RP device. J Heart Lung Transpl. 2015;34(12):1549–1560.
  • Randhawa VK, Al-Fares A, Tong MZY, et al. A Pragmatic Approach to Weaning Temporary Mechanical Circulatory Support: a State-of-the-Art Review. JACC Heart Fail. 2021;9(9):664–673.
  • Eleuteri K, Koerner MM, Horstmanshof D, et al. Temporary Circulatory Support and Extracorporeal Membrane Oxygenation. Cardiol Clin. 2018;36(4):473–485.
  • Rab T, Ratanapo S, Kern KB, et al. Cardiac Shock Care Centers: JACC Review Topic of the Week. J Am Coll Cardiol. 2018;72(16):1972–1980.
  • Esposito ML, Jablonski J, Kras A, et al. Maximum level of mobility with axillary deployment of the impella 5.0 is associated with improved survival. Int J Artif Organs. 2018;41(4):236–239.
  • Kaki A, Blank N, Alraies MC, et al. Axillary Artery Access for Mechanical Circulatory Support Devices in Patients With Prohibitive Peripheral Arterial Disease Presenting With Cardiogenic Shock. Am J Cardiol. 2019;123(10):1715–1721.
  • Seto AH, Abu-Fadel MS, Sparling JM, et al. Real-time ultrasound guidance facilitates femoral arterial access and reduces vascular complications: FAUST (Femoral Arterial Access with Ultrasound Trial). JACC Cardiovasc Interv. 2010;3(7):751–758.
  • Long A, Baran DA. Lingua Franca of Cardiogenic Shock: speaking the Same Language. Front Cardiovasc Med. 2021;8. DOI:https://doi.org/10.3389/fcvm.2021.691232
  • Baran DA, Long A, Badiye AP, et al. Prospective validation of the SCAI shock classification: single center analysis. Catheterization Cardiovasc Interventions. 2020;96(7):1339–1347.
  • Hanson ID, Tagami T, Mando R, et al. SCAI shock classification in acute myocardial infarction: insights from the National Cardiogenic Shock Initiative. Catheterization Cardiovasc Interventions. 2020;96(6):1137–1142.
  • Schrage B, Dabboura S, Yan I, et al. Application of the SCAI classification in a cohort of patients with cardiogenic shock. Catheterization Cardiovasc Interventions. 2020;96(3). DOI:https://doi.org/10.1002/ccd.28707
  • Tarantini G, Masiero G, Burzotta F, et al. Timing of Impella implantation and outcomes in cardiogenic shock or high-risk percutaneous coronary revascularization. Catheterization Cardiovasc Interventions. 2021;98(2). DOI:https://doi.org/10.1002/ccd.29674
  • Schäfer A, Westenfeld R, Sieweke JT, et al. Complete Revascularisation in Impella-Supported Infarct-Related Cardiogenic Shock Patients Is Associated With Improved Mortality. Front Cardiovasc Med. 2021;8. DOI:https://doi.org/10.3389/fcvm.2021.678748.
  • Aurigemma C, Burzotta F, Chieffo A, et al. Clinical Impact of Revascularization Extent in Patients Undergoing Impella-Protected PCI Enrolled in a Nationwide Registry. JACC Cardiovasc Interv. 2021;14(6):717–719.
  • Sharma S, Ghuneim A, Patel K, et al. TIMING OF IMPELLA USE IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH CARDIOGENIC SHOCK: a META-ANALYSIS. J Am Coll Cardiol. 2020;75(11):1497.
  • Basir MB, Schreiber T, Dixon S, et al. Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: the Detroit cardiogenic shock initiative. Catheterization Cardiovasc Interventions. 2018;91(3):454–461.
  • Hemradj S, Karami M, Sjauw KD, et al. Pre-PCI versus immediate post-PCI Impella initiation in acute myocardial infarction complicated by cardiogenic shock. PLoS ONE. 2020;15(7):e0235762.
  • Pieri M, Pappalardo F. Impella RP in the Treatment of Right Ventricular Failure: what We Know and Where We Go. J Cardiothorac Vasc Anesth. 2018;32(5):2339–2343.
  • Carrozzini M, Merlanti B, Olivieri GM, et al. Percutaneous RVAD with the Protek Duo for severe right ventricular primary graft dysfunction after heart transplant. J Heart Lung Transplant. 2021;40(7):580–583.
  • Ravichandran AK, Baran DA, Stelling K, et al. Outcomes with the tandem protek duo dual-lumen percutaneous right ventricular assist device. ASAIO J. 2018;64(4):570–572.
  • Agrawal N, Hameed F, Battel L, et al. CLINICAL OUTCOMES IN ACUTE RIGHT VENTRICULAR FAILURE WITH PERCUTANEOUS RIGHT VENTRICULAR ASSIST DEVICES: IMPELLA RP AND PROTEK DUO. J Am Coll Cardiol. 2021;77(18):634.
  • Salna M, Garan AR, Kirtane AJ, et al. Novel percutaneous dual-lumen cannula-based right ventricular assist device provides effective support for refractory right ventricular failure after left ventricular assist device implantation. Interact Cardiovasc Thorac Surg. 2020;30(4):499–506.
  • Kapur NK, Whitehead EH, Thayer KL, et al. The science of safety: complications associated with the use of mechanical circulatory support in cardiogenic shock and best practices to maximize safety. F1000Res. 2020;9:794.
  • Bertoldi LF, Delmas C, Hunziker P, et al. Escalation and de-escalation of mechanical circulatory support in cardiogenic shock. Eur Heart J Suppl. 2021;23(Supplement_A):A35–A40.
  • den Uil CA, Lagrand WK, van der Ent M, et al. Impaired microcirculation predicts poor outcome of patients with acute myocardial infarction complicated by cardiogenic shock. Eur Heart J. 2010;31(24):3032–3039.
  • Samsky M, Krucoff M, Althouse AD, et al. Clinical and regulatory landscape for cardiogenic shock: a report from the Cardiac Safety Research Consortium ThinkTank on cardiogenic shock. Am Heart J. 2020;219. DOI:https://doi.org/10.1016/j.ahj.2019.10.006.
  • Kontos MC, Gunderson MR, Zegre-Hemsey JK, et al. Prehospital Activation of Hospital Resources (PreAct) ST-Segment–Elevation Myocardial Infarction (STEMI): a Standardized Approach to Prehospital Activation and Direct to the Catheterization Laboratory for STEMI Recommendations From the American Heart Association’s Mission: lifeline Program. J Am Heart Assoc. 2020;9(2). DOI:https://doi.org/10.1161/JAHA.119.011963
  • Papolos AI, Kenigsberg BB, Berg DD, et al. Management and Outcomes of Cardiogenic Shock in Cardiac ICUs With Versus Without Shock Teams. J Am Coll Cardiol. 2021;78(13):1309–1317.
  • Kim DH. Mechanical Circulatory Support in Cardiogenic Shock: shock Team or Bust? Can J Cardiol. 2020;36(2):197–204.
  • van Diepen S, Katz JN, Albert NM, et al. Contemporary Management of Cardiogenic Shock: a Scientific Statement from the American Heart Association. Circulation. 2017;136(16). DOI:https://doi.org/10.1161/CIR.0000000000000525
  • Tehrani BN, Truesdell AG, Sherwood MW, et al. Standardized Team-Based Care for Cardiogenic Shock. J Am Coll Cardiol. 2019;73(13):1659–1669.
  • Basir MB, Kapur NK, Patel K, et al. Improved Outcomes Associated with the use of Shock Protocols: updates from the National Cardiogenic Shock Initiative. Catheterization Cardiovasc Interventions. 2019;93(7):1173–1183.
  • Taleb I, Koliopoulou AG, Tandar A, et al. Shock Team Approach in Refractory Cardiogenic Shock Requiring Short-Term Mechanical Circulatory Support: a Proof of Concept. Circulation. 2019;140(1):98–100.
  • Subramaniam AV, Barsness GW, Vallabhajosyula S, et al. Complications of Temporary Percutaneous Mechanical Circulatory Support for Cardiogenic Shock: an Appraisal of Contemporary Literature. Cardiol Ther. 2019;8(2). DOI:https://doi.org/10.1007/s40119-019-00152-8
  • Moghaddam N, van Diepen S, So D, et al. Cardiogenic shock teams and centres: a contemporary review of multidisciplinary care for cardiogenic shock. ESC Heart Fail. 2021;8(2). DOI:https://doi.org/10.1002/ehf2.13180
  • Burzotta F, Trani C, Doshi SN, et al. Impella ventricular support in clinical practice: collaborative viewpoint from a European expert user group. Int J Cardiol. 2015;201. DOI:https://doi.org/10.1016/j.ijcard.2015.07.065.
  • Esposito ML, Morine KJ, Annamalai SK, et al. Increased Plasma-Free Hemoglobin Levels Identify Hemolysis in Patients With Cardiogenic Shock and a Trans valvular Micro-Axial Flow Pump. Artif Organs. 2019;43(2):125–131.
  • Kim Y, Shapero K, Ahn SS, et al. Outcomes of mechanical circulatory support for acute myocardial infarction complicated by cardiogenic shock. Catheterization Cardiovasc Interventions. 2021. DOI:https://doi.org/10.1002/ccd.29834
  • Vallabhajosyula S, Prasad A, Sandhu GS, et al. Ten-year trends, predictors and outcomes of mechanical circulatory support in percutaneous coronary intervention for acute myocardial infarction with cardiogenic shock. EuroIntervention. 2021;16(15):e1254–e1261.
  • Dhruva SS, Ross JS, Mortazavi BJ, et al. Use of Mechanical Circulatory Support Devices Among Patients With Acute Myocardial Infarction Complicated by Cardiogenic Shock. JAMA network open. 2021;4(2):e2037748.
  • Chieffo A, Ancona MB, Burzotta F, et al. Observational multicentre registry of patients treated with IMPella mechanical circulatory support device in Italy: the IMP-IT registry. EuroIntervention. 2020;15(15):e1343–e1350.
  • Lauten A, Engström AE, Jung C, et al. Percutaneous left-ventricular support with the impella-2.5-assist device in acute cardiogenic shock results of the impella-EUROSHOCK-Registry. Circulation. 2013;6(1):23–30.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.