{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:55:54Z","timestamp":1791996954962,"version":"4.4.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Fonds Wetenschappelijk Onderzoek Flanders","award":["11P6X24N"],"award-info":[{"award-number":["11P6X24N"]}]},{"DOI":"10.13039\/100020297","name":"Abiomed","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020297","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Boehringer-Ingelheim"},{"name":"Bristol Myers Squibb"},{"DOI":"10.13039\/100019719","name":"Chiesi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019719","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022274","name":"Daiichi Sankyo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004339","name":"Sanofi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004339","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Pfizer-Bristol Myers Squibb Alliance"},{"DOI":"10.13039\/100008322","name":"CSL Behring","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Bleeding and thrombotic complications compromise outcomes in patients undergoing percutaneous mechanical circulatory support (pMCS) with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and\/or microaxial flow pumps like Impella\u2122. Antithrombotic practices are an important determinant of the coagulopathic risk, but standardization in the antithrombotic management during pMCS is lacking. This survey outlines European practices in antithrombotic management in adults on pMCS, making an initial effort to standardize practices, inform future trials, and enhance outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>This online cross-sectional survey was distributed through digital newsletters and social media platforms by the Association of Acute Cardiovascular Care and the European branch of the Extracorporeal Life Support Organization. The survey was available from 17 April 2023 to 23 May 2023. The target population were European clinicians involved in care for adults on pMCS. We included 105 responses from 26 European countries. Notably, 72.4% of the respondents adhered to locally established anticoagulation protocols, with unfractionated heparin (UFH) being the predominant anticoagulant (Impella\u2122: 97.0% and V-A ECMO: 96.1%). A minority of the respondents, 10.8 and 14.5%, respectively, utilized the anti-factor-Xa assay in parallel with activated partial thromboplastin time for UFH monitoring during Impella\u2122 and V-A ECMO support. Anticoagulant targets varied across institutions. Following acute coronary syndrome without percutaneous coronary intervention (PCI), 54.0 and 42.7% were administered dual antiplatelet therapy during Impella\u2122 and V-A ECMO support, increasing to 93.7 and 84.0% after PCI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Substantial heterogeneity in antithrombotic practices emerged from participants\u2019 responses, potentially contributing to variable device\u2013associated bleeding and thrombotic complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuae040","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T16:47:04Z","timestamp":1711385224000},"page":"458-469","source":"Crossref","is-referenced-by-count":10,"title":["European practices on antithrombotic management during percutaneous mechanical circulatory support in adults: a survey of the Association for Acute CardioVascular Care of the ESC and the European branch of the Extracorporeal Life Support Organization"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2830-624X","authenticated-orcid":false,"given":"Charlotte J","family":"Van Edom","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven , Herestraat 49, 3000 Leuven ,","place":["Belgium"]},{"name":"Department of Cardiovascular Sciences, University of Leuven , Herestraat 49, 3000 Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-092X","authenticated-orcid":false,"given":"Justyna","family":"Swol","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Paracelsus Medical University , Prof. Ernst-Nathan Str. 1, 90419 N\u00fcrnberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Castelein","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Onze-Lieve-Vrouwziekenhuis , Moorselbaan 164, 9300 Aalst ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9709-6082","authenticated-orcid":false,"given":"Mario","family":"Gramegna","sequence":"additional","affiliation":[{"name":"Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute , Via Olgettina 60, 20132 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1695-3378","authenticated-orcid":false,"given":"Kurt","family":"Huber","sequence":"additional","affiliation":[{"name":"3rd Department of Medicine, Cardiology and Intensive Care Medicine, Wilhelminen Hospital , W\u00e4hringer G\u00fcrtel 18-20, 1090 Vienna ,","place":["Austria"]},{"name":"Medical Faculty, Sigmund Freud University , Freudpl. 1+3, 1020 Vienna ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4800-6132","authenticated-orcid":false,"given":"Sergio","family":"Leonardi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Infective Disease, University of Pavia , 27100 Pavia ,","place":["Italy"]},{"name":"Fondazione, IRCCS Policlinico San Matteo , Piazzale Golgi 19, 27100 Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Regensburg , 93053 Regensburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9129-833X","authenticated-orcid":false,"given":"Federico","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo , Spalto Marengo 43, 15121 Alessandria ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6425-3360","authenticated-orcid":false,"given":"Susanna","family":"Price","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Hill End Rd, Harefield, Uxbridge UB9 6JH ,","place":["United Kingdom"]},{"name":"National Heart and Lung Institute, Imperial College , Guy Scadding Building, Dovehouse St., SW3 6LY London ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5219-4834","authenticated-orcid":false,"given":"Hannah","family":"Schaubroeck","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Ghent University Hospital, Ghent University , Corneel Heymanslaan 10, 9000 Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9041-3922","authenticated-orcid":false,"given":"Benedikt","family":"Schrage","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Heart and Vascular Center Hamburg , Martinistr. 52, 20251 Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9560-5138","authenticated-orcid":false,"given":"Guido","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, University of Pavia , 27100 Pavia ,","place":["Italy"]},{"name":"Intensive Care Unit, Fondazione Policlinico San Matteo IRCCS , Piazzale Golgi 19, 27100 Pavia ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leen","family":"Vercaemst","sequence":"additional","affiliation":[{"name":"Department of Perfusion, University Hospitals Leuven , Herestraat 49, 3000 Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1526-0652","authenticated-orcid":false,"given":"Pascal","family":"Vranckx","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, Jessa Ziekenhuis , Stadsomvaart 11, 3500 Hasselt ,","place":["Belgium"]},{"name":"Faculty of Medicine and Life Sciences, Hasselt University , Martelarenplein 42, 3500 Hasselt ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5151-6400","authenticated-orcid":false,"given":"Christophe","family":"Vandenbriele","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Onze-Lieve-Vrouwziekenhuis , Moorselbaan 164, 9300 Aalst ,","place":["Belgium"]},{"name":"Department of Critical Care, Royal Brompton and Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , Hill End Rd, Harefield, Uxbridge UB9 6JH ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,26]]},"reference":[{"key":"2024113000141957800_zuae040-B1","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1002\/ehf2.13202","article-title":"Temporal trends in incidence, causes, use of mechanical circulatory support and mortality in cardiogenic shock","volume":"8","author":"Schrage","year":"2021","journal-title":"ESC Heart Fail"},{"key":"2024113000141957800_zuae040-B2","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1007\/s00134-019-05897-3","article-title":"Why we need safer anticoagulant strategies for patients on short-term percutaneous mechanical circulatory support","volume":"46","author":"Vandenbriele","year":"2020","journal-title":"Intensive Care Med"},{"key":"2024113000141957800_zuae040-B3","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1016\/j.jcin.2023.05.043","article-title":"Management of bleeding and hemolysis during percutaneous microaxial flow pump support","volume":"16","author":"Van Edom","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"key":"2024113000141957800_zuae040-B4","doi-asserted-by":"crossref","first-page":"e569","DOI":"10.1097\/CCM.0000000000005466","article-title":"Longitudinal trends in bleeding complications on extracorporeal life support over the past two decades-extracorporeal life support organization registry analysis","volume":"50","author":"Willers","year":"2022","journal-title":"Crit Care Med"},{"key":"2024113000141957800_zuae040-B5","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1093\/ehjacc\/zuad129","article-title":"Complications in patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation therapy: distribution and relevance. 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