The last post is a great explanation.
When the Impella first came out, we were told by the reps that in the future it would replace the IABP, which is NOT true. There are many times that the IABP is indicated (ie incr perfusion of the coronary artaries).
Physicians were more reluctant to place it because:
1) it's a new technology and the older doc's are set in their ways.
2) The older Impella model was NOT user-friendly.
3) Unlike the IABP, the Impella line can easily migrate, causing the the tip of the catheter to move out of the LV. It required a bedside ECHO and a physician at the bedside to make sure that it was placed correctly, so it was constantly a worry. In fact, we would minimize repositioning for fear that the line would get tugged on.
3) That Impella line is about $35,000
The new model's interface is MUCH easier to understand. It basically can sense it's placement and will tell you if it's not in the right place. And since it rolled out last year, our physicians are using it much more because the outcomes have been good.