Rios SA, et al. - In this meta-analysis and Trial Sequential Analysis (TSA), authors compared the intra-aortic balloon pump (IABP) vs percutaneous ventricular assist devices (pVAD) (TandemHeart™ and the Impella®) during high-risk percutaneous coronary intervention (PCI) or cardiogenic shock (CS). They used PubMed, Cochrane Central Register of Controlled Trials, and EMBASE to search for randomized clinical trials (RCTs) and non-randomized studies that compared pVAD vs IABP in patients undergoing high-risk PCI or with CS. Short or long-term mortality did not differ when using IABP vs pVAD for high-risk PCI or CS. Use of pVAD appeared to be linked to more adverse events (acute kidney injury, limb ischemia, infection, major bleeding, and vascular injury) vs IABP, but this was not seen in the TSA.