Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Sardone, Andrea, Franchin, Luca, Moniaci, Diego, Colangelo, Salvatore, Colombo, Francesco, Boccuzzi, Giacomo, Iannaccone, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960206/
https://www.ncbi.nlm.nih.gov/pubmed/36836527
http://dx.doi.org/10.3390/jpm13020293
_version_ 1784895458776186880
author Sardone, Andrea
Franchin, Luca
Moniaci, Diego
Colangelo, Salvatore
Colombo, Francesco
Boccuzzi, Giacomo
Iannaccone, Mario
author_facet Sardone, Andrea
Franchin, Luca
Moniaci, Diego
Colangelo, Salvatore
Colombo, Francesco
Boccuzzi, Giacomo
Iannaccone, Mario
author_sort Sardone, Andrea
collection PubMed
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.
format Online
Article
Text
id pubmed-9960206
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99602062023-02-26 Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems Sardone, Andrea Franchin, Luca Moniaci, Diego Colangelo, Salvatore Colombo, Francesco Boccuzzi, Giacomo Iannaccone, Mario J Pers Med Review 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. MDPI 2023-02-06 /pmc/articles/PMC9960206/ /pubmed/36836527 http://dx.doi.org/10.3390/jpm13020293 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Sardone, Andrea
Franchin, Luca
Moniaci, Diego
Colangelo, Salvatore
Colombo, Francesco
Boccuzzi, Giacomo
Iannaccone, Mario
Management of Vascular Access in the Setting of Percutaneous Mechanical Circulatory Support (pMCS): Sheaths, Vascular Access and Closure Systems
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 Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9960206/
https://www.ncbi.nlm.nih.gov/pubmed/36836527
http://dx.doi.org/10.3390/jpm13020293
work_keys_str_mv AT sardoneandrea managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems
AT franchinluca managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems
AT moniacidiego managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems
AT colangelosalvatore managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems
AT colombofrancesco managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems
AT boccuzzigiacomo managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems
AT iannacconemario managementofvascularaccessinthesettingofpercutaneousmechanicalcirculatorysupportpmcssheathsvascularaccessandclosuresystems