Abstract
Treatment and outcome of ST-segment elevation infarction (STEMI) has been advancing with the development of pharmacologic agents and mechanical revascularization that have reduced mortality. In patients presenting STEMI, primary percutaneous coronary intervention (PPCI) is recommended reperfusion therapy. Access site is an important procedural aspect related to the successful of a PPCI. However, the clinical outcome of patients with STEMI complicated by cardiogenic shock (CS) remains unsatisfactory despite high rates of early revascularization. Conservative management with inotropes belongs furthermore to the initial therapie, but nowadays mechanical circulatory support devices become widely used for intensive treatment of patients with circulatory collapse refractory to conventional treatment. The percutaneous assist systems most commonly used in cardiogenic shock complicating an ST-elevation myocardial infarction are the intra-aortic ballon pump (IABP), the Impella pump, v-a ECMO and the Tandem Heart.
