First-in-Man Percutaneous Transaxillary Artery Placement and Removal of the Impella 5.0 Mechanical Circulatory...

We report on the fully percutaneous insertion and removal of the Impella 5.0 microaxial flow device via the axillary artery in a patient with cardiogenic shock and peripheral artery disease. Due to inadequate iliofemoral vasculature and desire for mobility, the axillary artery was felt to be the most appropriate access approach for temporary mechanical circulatory support. The procedure was well tolerated and the patient was supported for 17 days, at which time the device was safely removed in a fully percutaneous manner at the time of permanent left ventricular assist device placement. Percutaneous transaxillary placement of the Impella 5.0 device is a feasible support option in cardiogenic shock in patients with hostile iliofemoral disease.