Post-Closure Technique to Reduce Vascular Complications Related to Impella CP.

Autor: Hirst CS; Division of Cardiology and the CardioVascular Center, Tufts Medical Center, Boston, MA, United States of America; Ascension Saint John Heart and Vascular Institute, Ascension Saint John Hospital, Detroit, MI, United States of America., Thayer KL; Division of Cardiology and the CardioVascular Center, Tufts Medical Center, Boston, MA, United States of America., Harwani N; Tufts University School of Medicine, Boston, MA, United States of America., Kapur NK; Division of Cardiology and the CardioVascular Center, Tufts Medical Center, Boston, MA, United States of America. Electronic address: nkapur@tuftsmedicalcenter.org.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2022 Jun; Vol. 39, pp. 38-42. Date of Electronic Publication: 2021 Nov 03.
DOI: 10.1016/j.carrev.2021.10.008
Abstrakt: Background: Use of percutaneous mechanical circulatory support has grown exponentially. Vascular complications remain a growing concern and best practices for device removal do not exist. We describe a novel post-closure technique for the next generation Impella CP removal and immediate hemostasis.
Methods: This study is a single center, retrospective, exploratory analysis of 11 consecutive patients receiving an Impella CP for either high-risk PCI or cardiogenic shock and then referred for post-closure compared to 20 patients receiving manual compression for Impella CP removal between 2017 and 2019.
Results: Mean age range was 62.7-65.4 years and 50-65% male between groups. Average duration of Impella CP treatment ranged from 3.4 to 5.2 days. Patients referred for post-closure had significantly lower rates of all-cause adverse vascular events (0% versus 40%; n = 0/11 versus n = 8/20; p = 0.01). There was no significant difference in BARC 3 or greater bleeding, transfusion requirement, hospitalization duration or intensive care duration between removal strategies.
Conclusion: The novel post-closure technique may significantly reduce vascular complications associated with device removal and may improve clinical outcomes for these critically ill patients.
Competing Interests: Declaration of competing interest CSH, KLT report no conflicts of interest. NKK is currently funded by the National Institutes of Health (RO1HL139785, RO1H133215) and has received research funding from Abiomed Inc., Abbott Inc., Boston Scientific Inc., MD Start Inc. and Maquet Cardiovascular Inc.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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