Managing vascular access and closure for percutaneous mechanical circulatory support

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Vascular Surgery

Background:

• Vascular complications remain a significant risk in patients undergoing mechanical circulatory support (MCS).
• Minimizing vascular trauma during MCS procedures is crucial for patient recovery and survival.
• Safe and adequate arterial access is paramount for the effective use of percutaneous MCS.

Purpose of the Study:

• To review current techniques for large-bore arterial access in percutaneous MCS.
• To discuss the management of femoral arterial access, including maintenance, closure, and complications.
• To outline alternative arterial access routes for MCS delivery.

Main Methods:

• Review of state-of-the-art techniques for percutaneous large-bore arterial access.
• Discussion of femoral arterial access procedures and their associated complications.
• Concise description of alternative access routes, such as axillary artery access.

Main Results:

• Femoral arterial access is the most common approach for MCS, essential for large-bore procedures.
• Percutaneous axillary artery access serves as a viable alternative, particularly for patients with peripheral artery disease.
• Effective management strategies for access, maintenance, closure, and complications are critical.

Conclusions:

• Optimizing arterial access techniques is key to reducing vascular complications in MCS.
• Safe and efficient access directly impacts patient outcomes and the efficacy of MCS devices.
• Understanding both primary and alternative access routes enhances patient care in MCS.