{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:05:59Z","timestamp":1791043559724,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"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":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The use of temporary mechanical circulatory support (MCS) for patients with refractory cardiogenic shock has increased over the past decade. Impella devices (intravascular microaxial ventricular assist devices [VADs]) have become common MCS options but reportedly cause thrombocytopenia. Limited published data regarding the incidence or severity of microaxial VAD\u2010associated thrombocytopenia exists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The goal of this study was to determine the incidence, timing, and severity of thrombocytopenia in a microaxial VAD population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective multicenter review of electronic medical records identified all patients implanted with microaxial VAD at three US academic teaching hospitals between June 2015 and August 2017. Patients were excluded for short\u2010term procedural microaxial VAD use during percutaneous coronary intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010four patients underwent microaxial VAD insertion (95% for left\u2010sided support) during the observed time period. Support was in place for a median duration of 5.2 (interquartile range [IQR]: 2.4\u201310.0) days. Within 7 days postinsertion, 98.5% of patients developed thrombocytopenia (platelet count &lt;150,000\/\u03bcl) and 81.3% of patients experienced a\u00a0&gt;50% platelet decrease. Average platelet count nadir was 68,200\/\u03bcl or 63.9% from baseline occurring on median day 3.8 (IQR: 2.4\u20135.4). Twenty\u2010four patients (38.1%) were tested for heparin\u2010induced thrombocytopenia\u00a0by the heparin\u2010dependent antibody (HDA) test. All HDAs were either negative or had serotonin release assay negative confirmation. Postdevice removal, platelet counts returned to baseline or &gt;150,000\/\u03bcl in 63% of patients by Day 5.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Microaxial VAD\u2010associated\u00a0thrombocytopenia is common. Practitioners should consider this when evaluating supported patients for other causes of thrombocytopenia. Platelet counts return to preimplantation levels within days of device removal.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30520","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T17:58:18Z","timestamp":1670608698000},"page":"318-323","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Incidence and severity of thrombocytopenia associated with use of intravascular microaxial ventricular assist devices for treatment of cardiogenic shock"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3083-8050","authenticated-orcid":false,"given":"Jenna","family":"Goetz","sequence":"first","affiliation":[{"name":"Department of Pharmacy Barnes Jewish Hospital St Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Bream\u2010Rouwenhorst","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Hobbs","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Care University of Iowa Hospitals and Clinics Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip A.","family":"Horwitz","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine University of Iowa Carver College of Medicine Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3949\/ccjm.84gr.17002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-015-0119-9"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccl.2017.03.008"},{"key":"e_1_2_8_5_1","volume-title":"Impella 2.5 with the Automated Impella Controller Instructions for Use & Clinical Reference Manual","author":"Abiomed 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in impella devices for heparin\u2010induced thrombocytopenia","volume":"44","author":"Al\u2010Ayoubi AM","year":"2022","journal-title":"J Pharm Pract"},{"key":"e_1_2_8_17_1","volume-title":"Impella Update: Use of Sodium Bicarbonate in Impella Pumps","author":"Abiomed Inc","year":"2021"}],"container-title":["Catheterization and Cardiovascular 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