Single-access dual-injection technique (SADIT) for high-risk PCI with Impella CP

Area of Science:

• Interventional Cardiology
• Vascular Access Techniques
• Mechanical Circulatory Support

Background:

• Standard care for chronic total occlusion (CTO) percutaneous coronary interventions (PCI) involves dual arterial vascular access.
• Impella support during PCI may necessitate an additional vascular access site, increasing procedural complexity and risk.

Observation:

• A novel single-access, dual injection technique (SADIT) was developed and performed in a first-in-man case.
• The technique involved standard Impella CP insertion followed by placement of a 6 French sheath and a 4 French sheath at specific positions.

Findings:

• The single-access, dual injection technique (SADIT) successfully facilitated Impella-assisted coronary revascularization.
• This approach obviates the need for additional arterial access sites, thereby mitigating associated risks.

Implications:

• SADIT offers a simplified strategy for complex, high-risk PCI procedures requiring Impella support and dual coronary injections, such as CTO interventions.
• This technique has the potential to reduce vascular complications by minimizing the number of access sites used.