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Updated: Oct 17, 2025

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Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Novel Modification of Impella Sheath to Prevent Limb Ischemia
Sagar Mallikethi-Reddy1,2, Mahin R Khan1, Hafiz Khan1
1From the Division of Cardiology, McLaren Flint, Michigan State University and.
Abstract:
Limb ischemia is a dreaded complication of large-bore access during prolonged Impella support. We report a novel technique to modify 14F Impella sheath by creating two perfusion holes in the dorsal sheath surface to enable distal limb perfusion via dead space surrounding 9F Impella catheter in flow-occlusive iliofemoral arteries.

