{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:08:18Z","timestamp":1778825298505,"version":"3.51.4"},"reference-count":11,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T00:00:00Z","timestamp":1774137600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["24CDA1277194"],"award-info":[{"award-number":["24CDA1277194"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Mechanical circulatory support (MCS) devices can be helpful to maintain hemodynamic stability during high\u2010risk percutaneous coronary intervention (PCI). Iliofemoral arterial disease limits the use of transfemoral MCS devices. Impella 5.5, a surgical transaxillary MCS device, represents a viable option for MCS\u2010protected PCI. We report a 74\u2010year\u2010old man with prior endovascular aneurysm repair (EVAR), severe peripheral artery disease (PAD), and newly diagnosed NSTEMI was found to have three\u2010vessel and left main coronary disease with an ejection fraction (EF) of 13%. Due to aortoiliac occlusion, transfemoral MCS was not feasible. Instead, an Impella 5.5 was implanted via a right axillary artery graft, enabling successful orbital atherectomy and bifurcation PCI. In summary, axillary Impella 5.5 insertion is a viable option in anatomically complex patients where femoral access is contraindicated. This approach allows full left ventricular hemodynamic support for revascularization in otherwise inoperable patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70566","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T04:33:27Z","timestamp":1774240407000},"page":"1966-1969","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Protected Percutaneous Coronary Intervention With Impella 5.5 Pump in Severe Peripheral Artery Disease"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3581-2839","authenticated-orcid":false,"given":"Rohit B.","family":"Ponnada","sequence":"first","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atman K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhanuteja","family":"Pujari","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6842-2977","authenticated-orcid":false,"given":"Atharva M.","family":"Bhagwat","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ladislao","family":"Marrero\u2010Rivera","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Department of Internal Medicine, Division of Cardiology SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lolita","family":"Golemi","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Department of Internal Medicine, Division of Cardiology SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shilpkumar","family":"Arora","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Department of Internal Medicine, Division of Cardiology SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divya Ratan","family":"Verma","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Department of Internal Medicine, Division of Cardiology SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anh\u2010Thu","family":"Le","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Division of Cardiothoracic Surgery, Department of Surgery SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hersh","family":"Maniar","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Division of Cardiothoracic Surgery, Department of Surgery SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-9411","authenticated-orcid":false,"given":"Chien\u2010Jung","family":"Lin","sequence":"additional","affiliation":[{"name":"Saint Louis University School of Medicine St. Louis Missouri USA"},{"name":"Department of Internal Medicine, Division of Cardiology SSM Health Saint Louis University Hospital St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13164586"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjopen\/oeae007"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.15420\/usc.2022.26"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2022.02.006"},{"key":"e_1_2_6_6_1","unstructured":"PROTECT IV Trial. A Prospective Randomized Controlled Trial Evaluating Impella\u2010Supported PCI Versus Unsupported PCI in High\u2010Risk Patients. ClinicalTrials.gov identifier: NCT04763200. Updated May 2024 accessed June 24 2025 https:\/\/clinicaltrials.gov\/study\/NCT04763200."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001039"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.04.039"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001452"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8183.2011.00696.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.120.009657"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28994"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70566","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70566","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:18:42Z","timestamp":1778822322000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,22]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/ccd.70566"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70566","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,22]]},"assertion":[{"value":"2025-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}