{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T03:43:49Z","timestamp":1785815029441,"version":"3.56.0"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2021,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this study was to describe the feasibility and early outcomes of transcaval access for delivery of emergency mechanical circulatory support (MCS) in cardiogenic shock.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Vascular access for implantation of MCS in patients with cardiogenic shock is often challenging due to peripheral arterial disease and vasoconstriction. Transcaval delivery of MCS may be an alternative. We describe a series of patients we implanted an Impella 5.0 device, on\u2010table without CT planning, through a percutaneous transcaval access route.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten patients with progressive or refractory cardiogenic shock underwent Impella 5.0 implantation via transcaval access. Demographic, clinical and procedural variables and in\u2010hospital outcomes were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All ten underwent emergency implantation of the 7\u2009mm diameter Impella 5.0 device via transcaval access. Six were women, with median age of 55.5\u2009years (range, 29\u201369). Cardiogenic shock was attributed to idiopathic nonischemic cardiomyopathy (<jats:italic>n<\/jats:italic> = 4), myocarditis (<jats:italic>n<\/jats:italic> = 2), ischemic cardiomyopathy (<jats:italic>n<\/jats:italic> = 2), heart transplant rejection (<jats:italic>n<\/jats:italic> = 1), and unknown etiology (<jats:italic>n<\/jats:italic> = 1). Median duration of support was 92.1 hr (range, 21.2\u2013165.4). Seven (70%) survived to device explant, with six (60%) surviving to access port closure and discharge. Among survivors, five recovered heart function and one received destination therapy left ventricular assist device.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Transcaval access is feasible for emergency nonsurgical implantation of the Impella 5.0 device in cardiogenic shock with small or diseased iliofemoral arteries. This allows early institution of higher\u2010flow MCS than conventional femoral artery implantation of the 3.5 L Impella CP device, and enables a bridge\u2010to\u2010recovery or bridge\u2010to\u2010destination strategy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.29235","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T18:10:31Z","timestamp":1600971031000},"page":"555-564","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Transcaval access for the emergency delivery of 5.0 liters per minute mechanical circulatory support in cardiogenic shock"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1057-1280","authenticated-orcid":false,"given":"Majed","family":"Afana","sequence":"first","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Altawil","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3486-6753","authenticated-orcid":false,"given":"Mir","family":"Basir","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alqarqaz","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-5320","authenticated-orcid":false,"given":"Khaldoon","family":"Alaswad","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0334-6504","authenticated-orcid":false,"given":"Marvin","family":"Eng","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"},{"name":"Center for Structural Heart Disease Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Division of Cardiology Henry Ford Health System  Detroit Michigan USA"},{"name":"Center for Structural Heart Disease Henry Ford Health System  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1202-6673","authenticated-orcid":false,"given":"Robert J.","family":"Lederman","sequence":"additional","affiliation":[{"name":"Cardiovascular Branch, Division of Intramural Research National Heart Lung and Blood Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam B.","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"Structural Heart and Valve Center Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000525"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw128"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61783-3"},{"key":"e_1_2_8_5_1","first-page":"CD007398","article-title":"Intra\u2010aortic balloon pump counterpulsation (IABP) for myocardial infarction complicated by cardiogenic shock","volume":"3","author":"Unverzagt S","year":"2015","journal-title":"Cochrane Database Syst 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