01373nam a2200217   4500001000800000005001700008007000300025008004100028040000800069041000800077100003700085245006600122300002500188520070200213650002600915650002500941650002500966650003600991700002501027773010301052ESSALUD20260903095213.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aNallamothu, Brahmajee K. eAutor  aPrice of protection — Microaxial flow pump in high-risk PCI  apáginas: 1855-1856  aIn the catheterization laboratory, the most consequential decisions are frequently not about whether to treat, but rather about how far to extend treatment. Nowhere is that tension more apparent than in high-risk percutaneous coronary intervention (PCI). In these cases, the margin between a good outcome and a catastrophic one is narrow, and the instinct to add protection with mechanical circulatory support can be powerful. Transient ischemia induced by balloon inflation or atherectomy can precipitate physiological collapse in patients with little reserve. Yet, to date, randomized trials have not supported routine use of mechanical circulatory support in cases other than cardiogenic shock.  aCARDIOLOGÍA GENERAL  aENFERMEDAD CORONARIA  aINFARTO DE MIOCARDIO  aSOPORTE CIRCULATORIO MECÁNICO  aWanamaker, Brett L. 0 022717dMassachusetts NEJM GroupoNEJM015tThe New England Journal of Medicine wESSALUDx0028-4793