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Updated: Mar 1, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

A method for maintaining vascular access when Impella exchange is required.

B Scott Cook¹, Cleve Wilson¹, Brooke Kaiser¹

¹Department of Cardiology, University of Tennessee Medical Center, Knoxville, Tennessee.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions

|May 26, 2017

Summary

This case study presents a novel method for Impella catheter exchange during percutaneous coronary intervention (PCI). The technique maintains vascular access, avoiding repeat arterial puncture in patients on anticoagulation and dual antiplatelet therapy.

Keywords:

acute myocardial infarction/STEMI cardiogenic shock coronary artery disease mechanical circulatory support

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Last Updated: Mar 1, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

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Area of Science:

Cardiology
Interventional Cardiology
Medical Device Technology

Background:

Cardiogenic shock secondary to ST-elevation myocardial infarction (STEMI) requires immediate hemodynamic support.
Impella devices are used for temporary mechanical circulatory support during high-risk percutaneous coronary interventions (PCI).

Observation:

A 45-year-old male with anterolateral STEMI and cardiogenic shock required Impella support.
Following PCI, the Impella catheter kinked, necessitating an urgent exchange.
The patient was therapeutically anticoagulated and on dual antiplatelet therapy.

Findings:

A modified Impella catheter exchange technique was developed to maintain existing vascular access.
This method eliminated the need for a second arterial puncture during device exchange.
The modified technique ensured continued hemodynamic support without compromising patient safety.

Implications:

This approach offers a valuable strategy for managing Impella device complications in anticoagulated patients.
It potentially reduces procedural time, complications, and healthcare costs associated with repeat arterial access.
This technique may be applicable to other percutaneous device exchanges requiring maintained vascular access.