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- Title
Escalation from intra-aortic balloon pump to axillary impella 5.5 support: Staged removal of the femoral access.
- Authors
Sosa, Carlos Vazquez; Ohira, Suguru; Ahmad, Hasan; Isath, Ameesh; De La Pena, Corazon; Spielvogel, David; Kai, Masashi
- Abstract
Background: With the growing population of advanced heart failure, the use of Impella 5.5 has been increasing. Here, we report an effective strategy of removing the intra-aortic balloon pump (IABP) in the setting of escalation of support to Impella 5.5. Results: From January 1, 2022 to June 30, 2022, a total of 6 patients have undergone IABP removal during Impella 5.5 insertion. The IABP was subsequently removed over the long wire with manual compression on the femoral artery to control bleeding. An 8 or 9 Fr short sheath is inserted over the wire. Staged hemostasis was successfully performed in 4 patients, and the remaining two patients required escalation of support to veno-arterial membrane oxygenation as EC-PELLA utilizing the femoral arterial sheath. Conclusion: This does not only achieve secured hemostasis but also enables a smooth transition to further escalate support such as extracorporeal membrane oxygenation support, if necessary.
- Subjects
EXTRACORPOREAL membrane oxygenation; INTRA-aortic balloon counterpulsation; HEART assist devices; CATHETERIZATION; MEDICAL device removal; RETROSPECTIVE studies; HEART failure; HEMATOMA; TREATMENT effectiveness; GROIN; SURGICAL hemostasis; COMPRESSION therapy; DISEASE complications; CASE studies; FEMORAL artery; FLUOROSCOPY
- Publication
Perfusion, 2024, Vol 39, Issue 3, p469
- ISSN
0267-6591
- Publication type
Article
- DOI
10.1177/02676591221147431