Interventional procedure overview of percutaneous insertion of a catheter-based intravascular microaxial flow pump for cardiogenic shock
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Appendix A: Methods and literature search strategy
Methods and literature search strategy
NICE has identified studies and reviews relevant to catheter-based intravascular microaxial flow pump for cardiogenic shock from the medical literature.
Search strategy design and peer review
This search report is informed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S).
A NICE information specialist ran the literature searches on 29/05/25. See the search strategy history for the full search strategy for each database. Relevant published studies identified during consultation or resolution that are published after this date may also be considered for inclusion.
The principal search strategy was developed in MEDLINE ALL (Ovid interface). It was adapted for use in each of the databases listed in table 4a, taking into account the database's size, search functionality and subject coverage. The MEDLINE ALL strategy was quality assured by a NICE senior information specialist. All translated search strategies were peer reviewed to ensure their accuracy. The quality assurance and peer review procedures were adapted from the Peer Review of Electronic Search Strategies (PRESS) 2015 evidence-based checklist.
Review management
The search results were managed in EPPI‑Reviewer version 5 (EPPI‑R5). Duplicates were removed in EPPI‑R5 using a 2‑step process. First, automated deduplication was done using a high-value algorithm. Second, manual deduplication was used to assess low-probability matches. All decisions about inclusion, exclusion and deduplication were recorded and stored.
Limits and restrictions
The search was not limited by date or language.
The CENTRAL database search removed trial registry records and conference material. The Embase search excluded conference material.
The limit to remove animal studies in the searches is standard NICE practice, which has been adapted from Dickersin K, Scherer R, Lefebvre C (1994) Systematic Reviews: Identifying relevant studies for systematic reviews. BMJ 309(6964): 1286.
Main search
Search strategy history
MEDLINE ALL search strategy
1 Shock, Cardiogenic/ 11823
2 (Cardiogenic* adj4 shock*).tw. 17471
3 Heart Failure/ 156362
4 (heart adj4 failure).tw. 237316
5 Myocardial Infarction/ 185430
6 (((myocardial or heart) adj4 infarc*) or (heart adj4 attack*) or (cardiovascular* adj4 stroke*)).tw. 255205
7 Myocarditis/ 18213
8 (myocard* or carditis).tw. 466398
9 Cardiomyopathies/ 35439
10 Cardiomyopath*.tw. 95521
11 or/1-10 801927
12 (left adj4 ventric*).tw. 246176
13 Ventricular Function, Left/ 51337
14 12 or 13 255698
15 (Microaxial or micro-axial or axillary).tw. 43215
16 (((tube* or catheter*) and pump* and (valve* or intravascular)) or (flow adj4 pump*)).tw. 5352
17 mAFP.tw. 215
18 or/15-17 48602
19 14 and 18 1408
20 Heart-Assist Devices/ 19310
21 (heart adj4 assist* adj4 device*).tw. 1472
22 (Mechanical adj4 circulatory adj4 support*).tw. 6564
23 (intravascular adj4 support*).tw. 162
24 or/20-23 23544
25 11 and 19 and 24 686
26 Impella.tw. 1990
27 11 and 26 1569
28 SmartAssist*.tw. 10
29 25 or 27 or 28 2085
30 Animals/ not Humans/ 5307000
31 29 not 30 1984
Embase search strategy
1 cardiogenic shock/ 44785
2 (Cardiogenic* adj4 shock*).tw. 33787
3 heart failure/ 364889
4 (heart adj4 failure).tw. 406514
5 heart infarction/ 344388
6 (((myocardial or heart) adj4 infarc*) or (heart adj4 attack*) or (cardiovascular* adj4 stroke*)).tw. 379166
7 myocarditis/ 41095
8 (myocard* or carditis).tw. 670916
9 cardiomyopathy/ 79320
10 Cardiomyopath*.tw. 157940
11 or/1-10 1306176
12 (left adj4 ventric*).tw. 395559
13 heart left ventricle function/ 52902
14 12 or 13 406495
15 (Microaxial or micro-axial or axillary).tw. 66088
16 (((tube* or catheter*) and pump* and (valve* or intravascular)) or (flow adj4 pump*)).tw. 8471
17 mAFP.tw. 291
18 or/15-17 74487
19 14 and 18 2845
20 heart assist device/ 8266
21 (heart adj4 assist* adj4 device*).tw. 2636
22 (Mechanical adj4 circulatory adj4 support*).tw. 12235
23 (intravascular adj4 support*).tw. 239
24 or/20-23 21809
25 11 and 19 and 24 583
26 Impella.tw,dv,dm. 6488
27 11 and 26 5248
28 SmartAssist*.tw,dv,dm. 36
29 25 or 27 or 28 5602
30 Nonhuman/ not Human/ 5700800
31 29 not 30 5423
32 clinical trial.pt. 273748
33 31 not 32 5398
34 (conference abstract* or conference review or conference paper or conference proceeding).db,pt,su. 6270848
35 33 not 34 2827
Cochrane Library (CDSR and CENTRAL) search strategy
#1 MeSH descriptor: [Shock, Cardiogenic] this term only 506
#2 (Cardiogenic* NEAR/4 shock*) 1828
#3 MeSH descriptor: [Heart Failure] this term only 14442
#4 (heart NEAR/4 failure) 41487
#5 MeSH descriptor: [Myocardial Infarction] this term only 14471
#6 (((myocardial or heart) NEAR/4 infarc*) or (heart NEAR/4 attack*) or (cardiovascular* NEAR/4 stroke*)) 44651
#7 MeSH descriptor: [Myocarditis] this term only 143
#8 (myocard* or carditis) 56343
#9 MeSH descriptor: [Cardiomyopathies] this term only 994
#10 Cardiomyopath* 6201
#11 {OR #1-#10} 93892
#12 (left NEAR/4 ventric*) 27129
#13 MeSH descriptor: [Ventricular Function, Left] this term only 3966
#14 #12 or #13 27129
#15 (Microaxial or micro-axial or axillary) 6854
#16 (((tube* or catheter*) and pump* and (valve* or intravascular)) or (flow NEAR/4 pump*)) 503
#17 mAFP 9
#18 {OR #15-#17} 7336
#19 #14 AND #18 159
#20 MeSH descriptor: [Heart-Assist Devices] this term only 396
#21 (heart NEAR/4 assist* NEAR/4 device*) 525
#22 (Mechanical NEAR/4 circulatory NEAR/4 support*) 352
#23 (intravascular NEAR/4 support*) 12
#24 {OR #20-#23} 812
#25 #11 and #19 and #24 47
#26 Impella 181
#27 #11 and #26 158
#28 SmartAssist* 2
#29 #25 or #27 or #28 196
#30 "conference":pt or (clinicaltrials or trialsearch):so 824537
#31 #29 NOT #30 in Cochrane Reviews, Cochrane Protocols 2
#32 #29 NOT #30 in Trials 82
INAHTA HTA Database search strategy
1 (cardiogenic shock)[mh] 11
2 Cardiogenic* AND shock* 19
3 (heart failure)[mh] 271
4 heart AND failure 408
5 (Myocardial Infarction)[mh] 122
6 (((myocardial or heart) AND infarc*) or (heart AND attack*) or (cardiovascular* AND stroke*)) 304
7 (myocarditis)[mh] 2
8 myocard* or carditis 292
9 ( Cardiomyopathies)[mh] 25
10 Cardiomyopath* 54
11 #10 OR #9 OR #8 OR #7 OR #6 OR #5 OR #4 OR #3 OR #2 OR #1 823
12 left AND ventric* 110
13 (Ventricular Function, Left)[mh] 5
14 #13 OR #12 111
15 (Microaxial or micro-axial or axillary) 41
16 (((tube* or catheter*) and pump* and (valve* or intravascular)) or (flow AND pump*)) 11
17 mAFP 0
18 #17 OR #16 OR #15 51
19 #18 AND #14 5
20 (Heart-Assist Devices)[mh] 49
21 (heart AND assist* AND device*) 46
22 (Mechanical AND circulatory AND support*) 4
23 (intravascular AND support*) 9
24 #23 OR #22 OR #21 OR #20 77
25 #24 AND #19 AND #11 1
26 Impella 14
27 #26 AND #11 9
28 SmartAssist* 0
29 #28 OR #27 OR #25 10
Inclusion criteria
The following inclusion criteria were applied to the abstracts identified by the literature search.
Publication type: clinical studies were included with emphasis on identifying good quality studies. Abstracts were excluded if they did not report clinical outcomes. Reviews, editorials, and laboratory or animal studies, were also excluded and so were conference abstracts, because of the difficulty of appraising study methodology, unless they reported specific adverse events not available in the published literature.
People with cardiogenic shock.
Intervention or test: percutaneous insertion of a catheter-based intravascular microaxial flow pump.
Outcome: articles were retrieved if the abstract contained information relevant to the safety, efficacy, or both.
If selection criteria could not be determined from the abstracts the full paper was retrieved.
Potentially relevant studies not included in the main evidence summary are listed in Appendix B: Other relevant studies.
Find out more about how NICE selects the evidence for the committee.
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