Use of Impella cardiac axial flow pump for cardiogenic shock (A newer alternative)–How good is the evidence? RAFIQ AHMED BHAT 1 ;SYED MANZOOR ALI 2 ;YOOSUF ALI ASHRAF MUHAMMAD HUSSENBOCUS 3 ;AKANKSHA RATHI 4 ; JAVAID AKHTER BHAT 5 ;ABDUL ALEEM KHAN 6 ;SYED MAQBOOL 2 ;RAJA SAQIB IQBAL 7 ;MD MONOWARUL ISLAM 8 ; YONGSHENG QU 1 ;YOU ZHANG 1 ;YUXIAO SUN 1 ;WENTAO XIAO 1 ;ABHISHEK TIBREWAL 9 ;CHUANYU GAO 1, * 1 Zhengzhou University People’s Hospital, Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China 2 Department of Cardiology, Super Speciality Division, Government Medical College, Srinagar, India 3 Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China 4 Department of Community Medicine, Vedanta Institute of Medical Sciences, Palghar, India 5 State Key Laboratory of Crop Genetics and Germplasm Enhancement, Nanjing Agricultural University, Nanjing, China 6 Department of Orthopaedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, China 7 Department of Paediatrics, Batra Hospital and Medical Research Centre, New Delhi, India 8 Zhengzhou University First Affiliated Hospital, Zhengzhou, China 9 Department of Community Medicine, Institute of Biostatistics and Epidemiology, Gurgaon, India Key words: Cardiogenic shock, Hemodynamic support, Impella Cardiac Axial Pump, IABP, VA-ECMO Abstract: The adverse outcomes of a ventricular heart failure (left, right or biventricular) caused by cardiogenic shock are aggravated by lung oedema and organ mal perfusion. Despite advances in medical sciences, revascularisation and mechanical hemodynamic support have proved ineffective in reducing the mortality rate in such patients. A thorough study of the data available about cardio-vascular diseases reveals that the application of conventional methods of treatment are least helpful to practically restore normal functions of heart when it experiences end-stage systolic ventricular failure. Thus, to overcome the challenges and find alternatives to address this issue, percutaneous ventricular support devices/machines were designed and successfully introduced. These devices have revolutionized the treatment of ventricular heart failures and are now in use all over the world. In this review paper a newer mechanical circulatory support (MCS) device, Impella, has been discussed and compared with a few other devices like (Intra-aortic Balloon Pump (IABP), Extracorporeal Circulation (ECLS) and Veno-arterial Extracorporeal Membrane Oxygenation (VA-ECMO). This article studies the challenges being faced during the treatment of cardiogenic shock, and thoroughly discusses the use and effectiveness of Impella Cardiac Axial Pump in each emergency. It can be said that mechanical circulatory support (MCS) device use during percutaneous coronary intervention (PCI) should be individualized based on multiple factors with a recommended use in patients with the greatest potential benefit and a relatively low risk of device-related complications. The current literature suggests that the outcomes of use of Impella and other mechanical circulatory support devices like IABP and VA-ECMO are comparable. Though there seem to be a few advantages of Impella over the others, sufficiently powered, multi-centric, randomised control trials are needed to establish its superiority. Introduction Cardiogenic shock (CS) is defined as the state of critical end organ hypoperfusion, secondary to cardiac malfunction, as in the case of an acute myocardial infarction (AMI) (Mebazaa et al., 2018; Ibanez et al., 2018; van Diepen et al., 2017). The traditional management of cardiogenic shock involves early diagnosis and improvement of tissue perfusion by optimising oxygen delivery (Hajjar and Teboul, 2019). Cardiogenic shock remains a challenging condition with mortality rates of around 50% (Mandawat and Rao, 2017). To achieve a breakthrough in reducing mortalities and give a new lease of life to patients suffering from Acute Myocardial Infarction with cardiogenic shock (AMICS), percutaneous ventricular support devices have been introduced and successfully used *Address correspondence to: Chuanyu Gao, gaocy6802@163.com Received: 30 March 2021; Accepted: 13 August 2021 BIOCELL ech T Press Science 2022 46(5): 1139-1150 Doi: 10.32604/biocell.2022.016833 www.techscience.com/journal/biocell This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.