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Optimizing Anticoagulation Therapy when Utilizing Mechanical Circulatory Support Devices.

Maurizio Bertaina1, Luca Franchin1, Aleksandra Gąsecka2

  • 1Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, Turin, Italy.

Interventional Cardiology Clinics
|May 28, 2026
PubMed
Summary
This summary is machine-generated.

Hemorrhagic complications are common in mechanical circulatory support (MCS) patients, impacting outcomes. This review details strategies for preventing and managing bleeding during MCS implantation, support, and removal.

Keywords:
AnticoagulationBleedingCardiogenic shockMechanical circulatory supportMicroaxial flow pumpMyocardial infarction

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Area of Science:

  • Cardiology
  • Vascular Surgery
  • Critical Care Medicine

Background:

  • Hemorrhagic complications are frequent and significant in patients undergoing mechanical circulatory support (MCS).
  • Bleeding events occur in 10-40% of cardiogenic shock cases and 5-10% of high-risk percutaneous coronary interventions.
  • These complications prolong hospitalization, increase morbidity, and negatively affect patient outcomes.

Purpose of the Study:

  • To review the prevention and management of bleeding complications associated with mechanical circulatory support.
  • To provide insights into mitigating bleeding during MCS implantation, prolonged support, and device removal.

Main Methods:

  • Literature review focusing on bleeding complications in mechanical circulatory support.
  • Analysis of strategies for access-site bleeding prevention and management.
  • Examination of systemic bleeding causes during prolonged MCS support.

Main Results:

  • Access-site bleeding, often from large-bore sheaths, can be reduced with vascular imaging, ultrasound guidance, and effective closure techniques.
  • Systemic bleeding during prolonged support is linked to device hemocompatibility, antithrombotic therapies, and coagulopathies.
  • Effective management requires a multi-faceted approach addressing procedural and systemic factors.

Conclusions:

  • Preventing and managing hemorrhagic complications is crucial for improving outcomes in MCS patients.
  • Optimizing vascular access techniques and addressing systemic bleeding risks are key to patient safety.
  • This review offers guidance for clinicians caring for patients with mechanical circulatory support devices.