Journal article
Totally Percutaneous Insertion and Removal of Impella Device Using Axillary Artery in the Setting of Advanced Peripheral Artery Disease
The Journal of invasive cardiology, Vol.28(9), pp.374-380
09/01/2016
PMID: 27430667
Abstract
Traditionally, brachial and common femoral arteries have served as access sites of choice, with many operators recently converting to radial artery access for coronary angiography and percutaneous intervention due to literature suggesting reduced bleeding risk, better patient outcomes, and lower hospital-associated costs. However, radial access has limitations when percutaneous procedures requiring larger sheath sizes are performed. Six Fr sheaths are considered the limit for safe use with the radial artery given that the typical luminal diameter of the vessel is approximately 2 mm, while peripheral artery disease (PAD) may often limit use of the common femoral artery, particularly in patients with multiple co-morbid risk factors. Similarly, the brachial artery has fallen out of favor due to both thrombotic and bleeding risks, while also not safely and reliably accommodating sheaths larger than 7 Fr. Here we describe 3 cases of a new entirely percutaneous technique utilizing the axillary artery for delivery of Impella 2.5 (13.5 Fr) and CP (14 Fr) cardiac-assist devices for protected percutaneous coronary intervention in the setting of prohibitive PAD.
Details
- Title: Subtitle
- Totally Percutaneous Insertion and Removal of Impella Device Using Axillary Artery in the Setting of Advanced Peripheral Artery Disease
- Creators
- Rajiv Tayal - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USAMihir Barvalia - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USAZeshan Rana - Mary Washington Hosp, Fredericksburg, VA USABenjamin LeSar - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USAHumayun Iftikhar - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USASpas Kotev - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USAMarc Cohen - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USANajam Wasty - Newark Beth Israel Med Ctr, Dept Cardiol, C2,201 Lyons Ave Osborne Terrace, Newark, NJ 07112 USA
- Resource Type
- Journal article
- Publication Details
- The Journal of invasive cardiology, Vol.28(9), pp.374-380
- PMID
- 27430667
- NLM abbreviation
- J Invasive Cardiol
- ISSN
- 1042-3931
- eISSN
- 1557-2501
- Publisher
- H M P Communications
- Number of pages
- 7
- Language
- English
- Date published
- 09/01/2016
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984966855702771
Metrics
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