Abstract 16318: Using Arterial Recoil for Large Bore Access Closure After Impella Assist Device Removal
Khawaja M Talha, John G Winscott, Vishal Patel, Kellan E Ashley, Michael McMullan, Alejandro Lemor, William Campbell, Gabriel A Hernandez- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Background: The use of Impella assist device for high-risk percutaneous coronary interventions (HR-PCI) and cardiogenic shock (CS) has increased in the last decade and requires a large bore arterial access (LBA). However, LBA closure following Impella removal is associated with significant complications.
Objective: To describe the safety and efficacy of a novel method of LBA closure using arterial recoil following Impella removal.
Methods: A descriptive, retrospective review of electronic medical records in all patients that underwent LBA closure using this novel method from July 1, 2018, to June 30, 2022, was performed at the University of Mississippi Medical Center. The procedure involves controlled downsizing of the arterial sheath from 12 French (Fr) to 6 Fr with intermittent compression to allow patent hemostasis facilitated by arterial recoil. Baseline characteristics and outcomes including closure success, immediate or delayed (>6 hours) bleeding, and access site hematoma/pseudoaneurysm were included.
Results: Of 103 patients with Impella placement, 20 (19%) underwent LBA closure with the arterial recoil method. Patients were predominantly male (80%) and White (55%) with a mean age of 65
Conclusions: LBA closure post-Impella removal with this novel method is safe and effective. Further prospective studies are needed to ascertain its comparative efficacy.