• Nikhil Nalluri, Nileshkumar Patel, Samer Saouma, Viswajit Reddy Anugu, Dixitha Anugula, Deepak Asti, Varshil Mehta, Varun Kumar, Varunsiri Atti, Sushruth Edla, Rasleen K Grewal, Hafiz M Khan, Ritesh Kanotra, Gregory Maniatis, Ruben Kandov, James C Lafferty, Michael Dyal, Carlos E Alfonso, and Mauricio G Cohen.
• a Department of cardiology , Staten Island University Hospital , New York , NY , USA.
• Expert Rev Med Devices. 2017 Oct 1; 14 (10): 789-804.

IntroductionImpella is a catheter-based micro-axial flow pump placed across the aortic valve, and it is currently the only percutaneous left ventricular assist device approved for high-risk percutaneous coronary intervention and cardiogenic shock. Areas Covered: Even though several studies have repeatedly demonstrated the excellent hemodynamic profile of Impella in high-risk settings, it remains underutilized. Here we aim to provide an up-to-date summary of the available literature on Impellas use in High risk settings as well as the practical aspects of its usage. Expert Commentary: Percutaneous coronary interventions in high rsk settings have always been challenging for a physician. Impella 2.5 and CP, have been proven safe, cost effective and feasible in High Risk Percutaneous coronary Interventions with an excellent hemodynamic profile.

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