The Single-access for Hi-risk PCI (SHiP) technique.

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• The Impella CP percutaneous ventricular assist catheter typically requires a 14 French sheath for implantation.
• Performing additional diagnostic or therapeutic procedures often necessitates separate arterial access, increasing procedural time and complication risks.
• Limited arterial access in some patients presents a challenge for complex interventions.

Purpose of the Study:

• To introduce and evaluate the Single-access for Hi-risk PCI (SHiP) technique.
• To demonstrate a method for performing high-risk percutaneous coronary intervention (PCI) through the Impella CP access site.
• To reduce vascular complications and procedural time associated with multiple arterial accesses.

Main Methods:

• The SHiP technique involves accessing the hemostasis valve of the Impella insertion sheath.
• A micropuncture needle is used to pierce the valve, followed by dilation and wire exchange.
• A 7 French sheath is inserted alongside the Impella catheter for PCI within the main 14 French sheath.

Main Results:

• The study reports on a case series of 17 patients utilizing the SHiP technique.
• No instances of bleeding were observed during the procedure or post-sheath removal.
• No disruption of the Impella sheath integrity was noted.

Conclusions:

• The SHiP technique offers a safe and rapid method for single arterial access during high-risk PCI in patients requiring Impella support.
• This approach potentially minimizes vascular complications and streamlines procedures.
• Further investigation into the broader application of this technique is warranted.