Key result
Percutaneous use of the Impella 2.5 L device via the left axillary artery was successful for hemodynamic support in 2 patients undergoing high-risk PCI with severe aortoiliac disease.
Why the study?
Is the percutaneous left axillary artery approach for Impella 2.5 L circulatory support feasible in patients undergoing high-risk PCI with severe aortoiliac disease?
Case Report (n=2)
Is the percutaneous left axillary artery approach for Impella 2.5 L circulatory support feasible in patients undergoing high-risk PCI with severe aortoiliac disease?
The percutaneous left axillary artery approach is a feasible alternative for Impella 2.5 L insertion in high-risk PCI patients with severe aortoiliac disease precluding femoral access.
Supports axillary Impella access when femoral precluded; hypothesis-generating and should not yet change practice.
The use of the Impella 2.5 liter (L) device for hemodynamic support has been well described. The typical access site for the Impella 2.5 L device is the femoral artery. The use of the axillary and subclavian artery has been described via surgical cut down for the Impella 5 L device when femoral artery access is not possible. In patients with severe aortoiliac disease and difficult anatomy the femoral artery access for the Impella 2.5 L device is not feasible. We describe the successful percutaneous use of the Impella 2.5 L device for hemodynamic support via the left axillary artery in 2 patients undergoing high-risk PCI with concomitant severe aortoiliac disease.
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Lotun et al. (2012) conducted a case report in Severe aortoiliac arterial disease undergoing high-risk percutaneous coronary intervention (n=2). Percutaneous left axillary artery approach for Impella 2.5 L device was evaluated on Successful percutaneous use for hemodynamic support. Percutaneous use of the Impella 2.5 L device via the left axillary artery was successful for hemodynamic support in 2 patients undergoing high-risk PCI with severe aortoiliac disease.
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