Balloon pump before PCI? Nah.

High risk patients benefit from pre-operative intra-aortic balloon counterpulsation (IABP) prior to coronary artery bypass surgery. Would the same apply to patients undergoing percutaneous coronary intervention (PCI)?
A multicentre randomised controlled trial was conducted on over 300 patients with severe LV dysfunction and extensive coronary disease. The intervention was elective insertion of IABP before PCI. The composite primary end point of death, acute myocardial infarction, cerebrovascular event, or further revascularization at hospital discharge was not reduced in the intervention group.
These results do not support a strategy of routine IABP placement before PCI in all patients with severe left ventricular dysfunction and extensive coronary disease.

Elective Intra-aortic Balloon Counterpulsation During High-Risk Percutaneous Coronary Intervention
JAMA. 2010;304(8):867-874