title: Impella assisted transradial coronary intervention in patients with acute coronary syndromes and cardiogenic shock: case series.
abstract: Operators may feel apprehension when considering the transradial approach in patients with cardiogenic shock due to concerns of the need for femoral access for mechanical support. There is however potential benefit of transradial approach in this setting by reducing bleeding complications in patients on potent anticoagulant and antiplatelet agents. We report three cases of patients with cardiogenic shock with successful transradial intervention (TRI) whilst using unilateral femoral access for Impella (ABIOMED, Danvers, MA) mechanical support. In two cases, the need for mechanical support was not clear at the beginning of the procedure, and in the third there was a clear need to combine femoral and radial access due to pre-existing anatomic issues. Two patients required transfusion of red blood cells but otherwise there were no vascular access complications.
authors.affiliation: Cardiology Department, Lahey Clinic, Burlington, Massachusetts 01803, USA.
authors.forename: Brendan P
authors.initials: BP
authors.lastname: Bell
authors.forename: Ali F
authors.initials: AF
authors.lastname: Iqtidar
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Pyne
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000379:methods*; D017023:Coronary Angiography; D005260:Female; D005263:Femoral Artery; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017534:Radial Artery / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D012770:Shock, Cardiogenic / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome