TCT-1005 Optimal PCI Sheath for Low Profile Single-Access PCI With Impella CP Hemodynamic Support

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Abstract

Background: Impella CP (Abiomed) is a percutaneous left ventricular assist device introduced via a 14-F sheath in the femoral artery. Challenges may arise when both percutaneous coronary intervention (PCI) and Impella CP placement must be performed in patients with complex vascular access, leading to development of the single-access technique. A limitation with the single-access technique is optimal PCI sheath diameter resulting in reduced torqueability within the Impella CP sheath. The aim of our study was to characterize the optimal 7-F PCI sheath for the 14-F Low low-profile single-access procedure. Methods: The outer diameter measurement of the PCI sheaths were performed using Keyence 2-axis laser micrometer. Torqueability was assessed using the Mark-10 MFI advances digital force/torque indicator on a simulated single-access setting in a simulated skin pad. The 7-F PCI sheath and guide catheter samples were selected based on physician feedback. Results: The Cordis Brite Tip 11 cm, Cordis Brite Tip 35 cm, and Terumo Destination had the largest outer diameters (Figure A). The Merit Prelude and Terumo Glidesheath were the easiest to insert/remove because of their smaller outer diameters and hydrophilic coating (Figure B). The ABMD LP Companion sheath had the best torqueability (Figure C). The longer ABMD LP Companion sheath did not impact torqueability, but removal force increased by 50%. [Formula presented] Conclusion: The Merit Prelude and Terumo Glidesheath are optimal PCI sheaths for single access Impella-supported PCI because of smaller outer diameters and hydrophilic coating. The ABMD LP Companion demonstrated the best torqueability and the least effort to advance. Categories: OTHER: Vascular Access: Coronary.

Volume

84

Issue

18

First Page

B430

Find It @ Sladen

Share

COinS