Impella: pumps overview and access site management

Area of Science:

• Cardiovascular Engineering
• Medical Devices
• Interventional Cardiology

Background:

• The Impella system is a leading ventricular support device.
• It comprises microaxial pump catheters and an external controller.
• Four catheter types exist: Impella 2.5, CP, 5.0, and LD, differing in size and flow capacity.

Purpose of the Study:

• To detail the components and variations of the Impella left ventricular support system.
• To outline the insertion methods and common applications for different Impella models.
• To emphasize the importance of access site management for minimizing complications.

Main Methods:

• Description of Impella catheter types (2.5, CP, 5.0, LD) and their specifications.
• Explanation of percutaneous (femoral) and surgical (axillary, aorta) insertion approaches.
• Highlighting patient selection criteria for specific Impella devices, particularly for cardiogenic shock.

Main Results:

• Impella 2.5 and CP (12F/14F) are for percutaneous insertion (up to 2.5/4.1 L/min).
• Impella 5.0 and LD (21F) are for surgical insertion.
• Femoral access is common for percutaneous insertion, while axillary is an alternative for surgical insertion.
• Impella CP and 5.0 are frequently used in cardiogenic shock.

Conclusions:

• The Impella system provides diverse options for left ventricular support.
• Access site selection (femoral vs. axillary) depends on patient anatomy and support duration.
• Vigilant access site management is essential to prevent vascular complications with Impella use.