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Published on: June 12, 2021
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
Summary
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.
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.
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