In recent years, three randomised controlled trials questioned the use of the intra-aortic balloon pump (IABP) in populations of high-risk PCI (BCIS-1), acute myocardial infarction (CRISP-AMI), and cardiogenic shock (IABP-SHOCK II). This review describes these and other IABP trials, as well as their outcome on mortality. Clinical implications are addressed. There is a pressing need for adequately powered randomised controlled trials testing the optimal timing of mechanical circulatory support as well as device design in cardiogenic shock.
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