{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:52:38Z","timestamp":1787669558824,"version":"build-2736575974"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T00:00:00Z","timestamp":1726531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Impella 5.5\u00ae is commonly inserted via the axillary artery (AX) in patients with cardiogenic shock. The right AX has traditionally been preferred to avoid crossing the aortic arch, and a minimum diameter of 7\u2009mm has been recommended to accommodate the device (21 Fr). There is limited data on choice of laterality of access and AX size required, both in terms of technicality of the procedure as well as outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a single\u2010center retrospective cohort analysis of patients who underwent Impella 5.5\u00ae implantation between December 2020 and February 2024 (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200975). Data including demographics and outcomes were stratified both by diameter (small, &lt;7\u2009mm vs. normal, \u22657\u2009mm) and laterality of access (right vs. left). Adverse events included stroke, limb ischemia, procedural bleeding or infection, and unplanned explant due to complications. Delivery time was defined as time from advancing the first wire to activation of the device.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AX approach was attempted in all (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200974) but one requiring innominate access, with a technical success rate of 95.9% (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200971\/74). The mean age was 58.8\u2009\u00b1\u200913.3\u2009years, with 81.1% males. The median delivery time was 7.0 (25th, 75th percentiles: 4.0, 11.5) min with a median support duration of 13 (7.7, 24) days. Ten patients (13.5%) had a small AX, with a mean diameter of 6.3\u2009\u00b1\u20090.5\u2009mm and were more likely to be younger compared to the normal AX group. Fifty\u2010nine patients (79.7%) had insertion via the right AX. Median delivery time was comparable across all groups (small, 5.4 [3.5, 10.9] vs. normal, 7 [4.0, 12.1] min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.59) and (right, 10.4 [5.3, 15.2] vs. left, 6 [3.7, 10.4] min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.35). There was no difference between the rates of stroke, ischemia, bleeding, or infection when comparing by size or laterality. Survival to discharge was 59.5%, with 21.1% mortality on support, all in patients with a normal AX diameter, but with no difference between right versus left.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our study, laterality and a small diameter of AX access did not affect outcomes of Impella 5.5\u00ae, with a similar safety profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aor.14861","type":"journal-article","created":{"date-parts":[[2024,9,17]],"date-time":"2024-09-17T13:38:22Z","timestamp":1726580302000},"page":"146-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Axillary artery access considerations in Impella 5.5\u00a0insertion: Insights from exclusive axillary approach for\u00a0successful support"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8685-9658","authenticated-orcid":false,"given":"Shazli","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Cardiology Westchester Medical Center  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7992-8113","authenticated-orcid":false,"given":"Ameesh","family":"Isath","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westchester Medical Center  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7179-9786","authenticated-orcid":false,"given":"Vasiliki","family":"Gregory","sequence":"additional","affiliation":[{"name":"New York Medical College  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy","family":"Elgar","sequence":"additional","affiliation":[{"name":"New York Medical College  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avi","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westchester Medical Center  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed A.","family":"Haidry","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westchester Medical Center  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Cardiology Westchester Medical Center  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8433-7214","authenticated-orcid":false,"given":"Sooyun Caroline","family":"Tavolacci","sequence":"additional","affiliation":[{"name":"Graduate School of Biomedical Sciences Ichan School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Shimamura","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery Westchester Medical Center  Valhalla New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0247-865X","authenticated-orcid":false,"given":"Suguru","family":"Ohira","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery Westchester Medical Center  Valhalla New York 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