Use of a vascular sheath in the axillary artery: As an alternative access approach for placing an impella 5.0 device

Ankur S. Shah, Richard Lee, Dawn S. Hui, Michael J. Lim, Robert H. Neumayr, Joshua M. Stolker

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Many patients who are in cardiogenic shock need mechanical support for clinical stabilization after acute insults such as myocardial infarction. However, the placement of advanced devices can be hindered by anatomic constraints or the physiologic sequelae of shock, as we describe in this report. A 67-year-old woman with prior coronary artery bypass grafting and extensive chestwall scarring from previous defibrillator implantations presented with myocardial infarction and refractory cardiogenic shock. The patient’s vascular anatomy and prior surgery precluded conventional percutaneous implantation of an Impella 5.0 ventricular support device. We delivered the Impella device through the patient’s tortuous, vasoconstricted axillary artery with use of a vascular sheath and other percutaneous techniques. The success of this approach suggests that combining the expertise of cardiologists and cardiovascular surgeons can improve the outcomes of patients with complex anatomic issues.

Original languageEnglish (US)
Pages (from-to)385-388
Number of pages4
JournalTexas Heart Institute Journal
Volume42
Issue number4
DOIs
StatePublished - Aug 3 2015
Externally publishedYes

Keywords

  • Angioplasty, balloon, coronary/instrumentation/ methods
  • Coronary artery disease/complications/ therapy
  • Equipment design
  • Extremities/blood supply
  • Heart-assist devices
  • Knowledge bases
  • Myocardial infarction/complications
  • Percutaneous coronary intervention/methods
  • Shock, cardiogenic/surgery
  • Treatment outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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