Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems
The use of percutaneous mechanical circulatory support (pMCS), such as intra-aortic balloon pump, Impella, TandemHeart and VA-ECMO, in the setting of cardiogenic shock or in protect percutaneous coronary intervention (protect-PCI) is rapidly increasing in clinical practice. The major problem related...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/13/2/293 |
| _version_ | 1797619968139853824 |
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| author | Andrea Sardone Luca Franchin Diego Moniaci Salvatore Colangelo Francesco Colombo Giacomo Boccuzzi Mario Iannaccone |
| author_facet | Andrea Sardone Luca Franchin Diego Moniaci Salvatore Colangelo Francesco Colombo Giacomo Boccuzzi Mario Iannaccone |
| author_sort | Andrea Sardone |
| collection | DOAJ |
| description | The use of percutaneous mechanical circulatory support (pMCS), such as intra-aortic balloon pump, Impella, TandemHeart and VA-ECMO, in the setting of cardiogenic shock or in protect percutaneous coronary intervention (protect-PCI) is rapidly increasing in clinical practice. The major problem related to the use of pMCS is the management of all the device-related complications and of any vascular injury. MCS often requires large-bore access, if compared with common PCI, and for this reason the correct management of vascular access is a crucial point. The correct use of these devices in catheterization laboratories requires specific knowledge such as the correct evaluation of the vascular access performed, when possible, with advance imaging techniques in order to choose a percutaneous or a surgical approach. In addition to conventional transfemoral access, other types of access, such as transaxillary/subclavial access and the transcaval approach, have emerged over the years. These other approaches require advanced skills of the operators and a multidisciplinary team with dedicated physicians. Another important part of the management of vascular access is the closure systems used for hemostasis. Currently, two types of devices are typically used in the lab: suture-based or plug-based ones. In this review we want to describe all these aspects related to the management of vascular access in pMCS and describe, finally, a case report from our center’s experience. |
| first_indexed | 2024-03-11T08:34:34Z |
| format | Article |
| id | doaj.art-6968276382d64305804233f261070237 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-11T08:34:34Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-6968276382d64305804233f2610702372023-11-16T21:33:25ZengMDPI AGJournal of Personalized Medicine2075-44262023-02-0113229310.3390/jpm13020293Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure SystemsAndrea Sardone0Luca Franchin1Diego Moniaci2Salvatore Colangelo3Francesco Colombo4Giacomo Boccuzzi5Mario Iannaccone6Division of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyDivision of Vascular Surgery, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyDivision of Cardiology, San Giovanni Bosco Hospital, ASL Città di Torino, 10100 Turin, ItalyThe use of percutaneous mechanical circulatory support (pMCS), such as intra-aortic balloon pump, Impella, TandemHeart and VA-ECMO, in the setting of cardiogenic shock or in protect percutaneous coronary intervention (protect-PCI) is rapidly increasing in clinical practice. The major problem related to the use of pMCS is the management of all the device-related complications and of any vascular injury. MCS often requires large-bore access, if compared with common PCI, and for this reason the correct management of vascular access is a crucial point. The correct use of these devices in catheterization laboratories requires specific knowledge such as the correct evaluation of the vascular access performed, when possible, with advance imaging techniques in order to choose a percutaneous or a surgical approach. In addition to conventional transfemoral access, other types of access, such as transaxillary/subclavial access and the transcaval approach, have emerged over the years. These other approaches require advanced skills of the operators and a multidisciplinary team with dedicated physicians. Another important part of the management of vascular access is the closure systems used for hemostasis. Currently, two types of devices are typically used in the lab: suture-based or plug-based ones. In this review we want to describe all these aspects related to the management of vascular access in pMCS and describe, finally, a case report from our center’s experience.https://www.mdpi.com/2075-4426/13/2/293vascular managementmechanical circulatory supportprotect-PCIcardiogenic shock |
| spellingShingle | Andrea Sardone Luca Franchin Diego Moniaci Salvatore Colangelo Francesco Colombo Giacomo Boccuzzi Mario Iannaccone Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems Journal of Personalized Medicine vascular management mechanical circulatory support protect-PCI cardiogenic shock |
| title | Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems |
| title_full | Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems |
| title_fullStr | Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems |
| title_full_unstemmed | Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems |
| title_short | Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems |
| title_sort | management of vascular access in the setting of percutaneous mechanical circulatory support pmcs sheaths vascular access and closure systems |
| topic | vascular management mechanical circulatory support protect-PCI cardiogenic shock |
| url | https://www.mdpi.com/2075-4426/13/2/293 |
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