{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T17:27:19Z","timestamp":1782408439321,"version":"3.54.5"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"Supplement_J","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Abiomed Europe GmbH to cover publication costs of each manuscript"},{"name":"Abiomed GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Interest in the use of percutaneous left ventricular assist devices (p-LVADs) for patients undergoing high-risk percutaneous coronary intervention (PCI) is growing rapidly. The Impella\u2122 (Abiomed Inc.) is a catheter-based continuous micro-axial flow pump that preserves haemodynamic support during high-risk PCI. Anticoagulation is required to counteract the activation of the coagulation system by the patient\u2019s procoagulant state and the foreign-body surface of the pump. Excessive anticoagulation and the effect of dual antiplatelet therapy (DAPT) increase the risk of bleeding. Inadequate anticoagulation leads to thrombus formation and device dysfunction. The precarious balance between bleeding and thrombosis in patients with p-LVAD support is often the primary reason that patients\u2019 outcomes are jeopardized. In this chapter, we will discuss anticoagulation strategies and anticoagulant management in the setting of protected PCI. This includes anticoagulant therapy with unfractionated heparin, direct thrombin inhibitors, DAPT, purge blockage prevention by bicarbonate-based purge solution, and monitoring by activated clotting time, partial thromboplastin time, as well as anti-factor Xa levels. Here, we provide a standardized approach to the management of peri-interventional anticoagulation in patients undergoing protected PCI.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suac066","type":"journal-article","created":{"date-parts":[[2022,9,10]],"date-time":"2022-09-10T01:16:14Z","timestamp":1662772574000},"page":"J17-J24","source":"Crossref","is-referenced-by-count":9,"title":["What is known in pre-, peri-, and post-procedural anticoagulation in micro-axial flow pump protected percutaneous coronary intervention?"],"prefix":"10.1093","volume":"24","author":[{"given":"J\u00fcrgen","family":"Leick","sequence":"first","affiliation":[{"name":"Heartcenter Trier, Krankenhaus der Barmherzigen Br\u00fcder Trier , Nordallee 1, 54296 Trier , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Grottke","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, RWTH Aachen University Hospital , 52074 Aachen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Oezkur","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University Hospital Mainz , 55131 Mainz , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norman","family":"Mangner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Technische Universitaet Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Sanna","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Fondazione Policlinico A. Gemelli IRCCS, Universit\u00e0 Cattolica del Sacro Cuore , 00168 Rome , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Al Rashid","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, Medical Faculty, University Hospital Essen , 45147 Essen , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Vandenbriele","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Sciences, University Hospitals Leuven , 3000 Leuven , Belgium"},{"name":"Royal Brompton and Harefield NHS Foundation Trust , SW36LP London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"2022120814452282900_suac066-B1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1002\/ccd.28560","article-title":"Vascular complications associated with 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