Single-access dual-injection technique (SADIT) for high-risk PCI with Impella CP

Catheter Cardiovasc Interv. 2021 Nov 15;98(6):1138-1140. doi: 10.1002/ccd.29804. Epub 2021 Jun 8.

Abstract

The use of two arterial vascular accesses is now the standard of care in chronic total occlusion (CTO) percutaneous coronary interventions (PCI). When Impella support is needed, an additional vascular access may be necessary. We describe the first-in-man single-access, dual injection technique (SADIT). The Impella CP device was inserted in the left ventricle in the standard fashion. Subsequently, a 6 French sheath was placed at the "10 o clock" position and a second 4 French sheath was at the "5 o clock" position. This technique obviates the need for additional arterial access sites and potentially risk of complications. The SADIT technique is a simple way to perform high-risk, Impella-assisted coronary revascularization procedures necessitating dual coronary injections like CTO interventions. This strategy avoids unnecessary vascular complications from multiple access sites.

Keywords: CTO; Impella complications; angiography; complex PCI; coronary; mechanical circulatory support; percutaneous coronary intervention; vascular access.

Publication types

  • Case Reports

MeSH terms

  • Heart Ventricles
  • Heart-Assist Devices*
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Punctures
  • Treatment Outcome