Mechanical Cardiopulmonary Resuscitation - Assisted Percutaneous Coronary Intervention during Cardiac Arrest: Feasibility and Outcomes.
Abstract
Cardiac arrest complicating acute coronary syndromes requires immediate coronary reperfusion; however, performing percutaneous coronary intervention (PCI) during active manual cardiopulmonary resuscitation (CPR) presents significant technical challenges. The Lund University Cardiac Arrest System (LUCAS) provides automated mechanical chest compressions and enables uninterrupted CPR during coronary angiography and PCI. Existing evidence is primarily limited to case reports and small observational studies, mechanical CPR has emerged as a practical adjunct in catheterization laboratories where manual compressions are unsafe or logistically challenging. We report two cases from our center in which LUCAS-assisted PCI was performed during ongoing cardiac arrest in the setting of cardiogenic shock and acute coronary syndromes, alongside a structured narrative synthesis of contemporary literature addressing feasibility, procedural considerations, and clinical outcomes. Mechanical chest compressions allowed uninterrupted angiography and successful revascularization in both cases, with return of spontaneous circulation achieved in 1 patient. Despite procedural success, survival remained poor, reflecting severe global ischemia and metabolic derangement. LUCAS-assisted PCI is a technically feasible strategy that facilitates coronary reperfusion in carefully selected patients. Evidence of survival benefit remains limited and derives predominantly from observational studies and case reports rather than randomized controlled trials. The role of extracorporeal CPR as a complementary or alternative strategy warrants explicit consideration at appropriately resourced centers. Improved patient selection and integration into structured resuscitation pathways may enhance clinical outcomes.
Related
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- Efficacy and safety of mechanical chest compression compared with manual cardiopulmonary resuscitation in adult non-traumatic cardiac arrest: a systematic review of the literature
- Transport mechanical ventilation during cardiopulmonary resuscitation in out-of-hospital cardiac arrest: an exploratory prehospital pilot study
- Prognostic Impact of Transient Return of Spontaneous Circulation According to Low-Flow Time in Patients with Out-of-Hospital Cardiac Arrest Undergoing Extracorporeal Cardiopulmonary Resuscitation: A Nationwide Cohort Study
- Healthcare providers’ confidence, satisfaction, and perceived preparedness following a multicomponent simulation-based cardiopulmonary resuscitation training program in Gaza
BibTeX
@article{triantafyllis2026mechanical,
title = {{Mechanical Cardiopulmonary Resuscitation - Assisted Percutaneous Coronary Intervention during Cardiac Arrest: Feasibility and Outcomes.}},
author = {Andreas S Triantafyllis and Sotirios C Kotoulas and Ibraheem Aqeel and Eleni Karapedi and Konstantinos Antoniades and Agoritsa M Pervana and Georgios Sotiris and Angeliki Kolyda and Andreas Giannakopoulos and Leonidas E Poulimenos},
journal = {Medical principles and practice : international journal of the Kuwait University, Health Science Centre},
year = {2026},
month = oct,
doi = {10.1159/mpp/adpag012},
url = {https://europepmc.org/article/MED/42879381},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Mechanical Cardiopulmonary Resuscitation - Assisted Percutaneous Coronary Intervention during Cardiac Arrest: Feasibility and Outcomes.
AU - Andreas S Triantafyllis
AU - Sotirios C Kotoulas
AU - Ibraheem Aqeel
AU - Eleni Karapedi
AU - Konstantinos Antoniades
AU - Agoritsa M Pervana
AU - Georgios Sotiris
AU - Angeliki Kolyda
AU - Andreas Giannakopoulos
AU - Leonidas E Poulimenos
PY - 2026
DA - 2026/10/15
JO - Medical principles and practice : international journal of the Kuwait University, Health Science Centre
DO - 10.1159/mpp/adpag012
UR - https://europepmc.org/article/MED/42879381
AB - Cardiac arrest complicating acute coronary syndromes requires immediate coronary reperfusion; however, performing percutaneous coronary intervention (PCI) during active manual cardiopulmonary resuscitation (CPR) presents significant technical challenges. The Lund University Cardiac Arrest System (LUCAS) provides automated mechanical chest compressions and enables uninterrupted CPR during coronary angiography and PCI. Existing evidence is primarily limited to case reports and small observational studies, mechanical CPR has emerged as a practical adjunct in catheterization laboratories where manual compressions are unsafe or logistically challenging. We report two cases from our center in which LUCAS-assisted PCI was performed during ongoing cardiac arrest in the setting of cardiogenic shock and acute coronary syndromes, alongside a structured narrative synthesis of contemporary literature addressing feasibility, procedural considerations, and clinical outcomes. Mechanical chest compressions allowed uninterrupted angiography and successful revascularization in both cases, with return of spontaneous circulation achieved in 1 patient. Despite procedural success, survival remained poor, reflecting severe global ischemia and metabolic derangement. LUCAS-assisted PCI is a technically feasible strategy that facilitates coronary reperfusion in carefully selected patients. Evidence of survival benefit remains limited and derives predominantly from observational studies and case reports rather than randomized controlled trials. The role of extracorporeal CPR as a complementary or alternative strategy warrants explicit consideration at appropriately resourced centers. Improved patient selection and integration into structured resuscitation pathways may enhance clinical outcomes.
SN - 1011-7571
SN - 1423-0151
ER -