{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:34:02Z","timestamp":1791045242568,"version":"4.1.0"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T00:00:00Z","timestamp":1551657600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Interventional Cardiology"],"published-print":{"date-parts":[[2019,3,4]]},"abstract":"<jats:p><jats:italic>Objectives<\/jats:italic>. To characterize anticoagulation practices with the Impella percutaneous ventricular assist device (pVAD).<jats:italic> Background<\/jats:italic>. Managing anticoagulation in patients being supported by the Impella pVAD is made challenging by several unique features of the device. These include the release of a dextrose-based purge solution containing unfractionated heparin (UFH), the need to concurrently administer systemic anticoagulation with intravenous UFH, and the lack of an alternative strategy in patients with contraindications to UFH.<jats:italic> Methods<\/jats:italic>. To characterize anticoagulation practices with the Impella pVAD, we conducted a survey of centers in the United States performing a high volume of Impella cases, which we defined as &gt; 1 per month. Centers were contacted via email or phone and individuals who agreed to participate were provided with a link to complete the survey online. The primary measures of interest were variations in practice across centers and variations from the manufacturer\u2019s recommendations.<jats:italic> Results<\/jats:italic>. Practices varied considerably among respondents (65 of 182 centers, or 35.7%) and often diverged from manufacturer recommendations. Approximately half of centers (52.4%) reported using a UFH concentration of 50 units\/mL in the purge solution, whereas most of the remaining centers (41.3%) reported using lower concentrations. Strategies for the initiation and adjustment of systemic therapy also varied, as did practices for routinely monitoring for hemolysis. Nearly one-fifth of centers (16.7%) had not developed an alternative strategy for the purge solution in patients with contraindications to UFH. Most centers (58.4%) reported using argatroban or bivalirudin in this scenario, a strategy that diverges from the manufacturer\u2019s recommendations.<jats:italic> Conclusions<\/jats:italic>. Given these findings, studies to determine a systematic approach to anticoagulation with the Impella device are warranted.<\/jats:p>","DOI":"10.1155\/2019\/3791307","type":"journal-article","created":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T18:42:46Z","timestamp":1551724966000},"page":"1-6","source":"Crossref","is-referenced-by-count":46,"title":["Survey of Anticoagulation Practices with the Impella Percutaneous Ventricular Assist Device at High-Volume Centers"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3867-070X","authenticated-orcid":true,"given":"Brent N.","family":"Reed","sequence":"first","affiliation":[{"name":"University of Maryland School of Pharmacy, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"DiDomenico","sequence":"additional","affiliation":[{"name":"University of Illinois at Chicago, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Erin","family":"Allender","sequence":"additional","affiliation":[{"name":"WakeMed Health & Hospitals, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-3751","authenticated-orcid":true,"given":"James C.","family":"Coons","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Pharmacy and UPMC Presbyterian Hospital, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna F.","family":"Cox","sequence":"additional","affiliation":[{"name":"Palmetto Health Richland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Johnson","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie S.","family":"Oliphant","sequence":"additional","affiliation":[{"name":"Methodist Healthcare-University Hospital, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas L.","family":"Jennings","sequence":"additional","affiliation":[{"name":"New York Presbyterian Columbia University Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1016\/j.jacc.2011.08.007","volume":"58","year":"2011","journal-title":"JACC: Journal of the American College of Cardiology"},{"key":"2","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/j.jacc.2013.05.019","volume":"62","year":"2013","journal-title":"Journal of the American College of Cardiology"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.05.065"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.098194"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.10.022"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1177\/1060028013503623"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1995"},{"key":"10","year":"2018","journal-title":"Journal of Pharmacy Practice"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000244"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp160212"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1177\/0897190017727191"},{"key":"14","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000290"},{"key":"15","year":"2018","journal-title":"Artificial Organs"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1177\/00131640021970934"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.01.789"}],"container-title":["Journal of Interventional Cardiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/jitc\/2019\/3791307.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jitc\/2019\/3791307.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jitc\/2019\/3791307.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T18:42:49Z","timestamp":1551724969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/jitc\/2019\/3791307\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,4]]},"references-count":15,"alternative-id":["3791307","3791307"],"URL":"https:\/\/doi.org\/10.1155\/2019\/3791307","relation":{},"ISSN":["0896-4327","1540-8183"],"issn-type":[{"value":"0896-4327","type":"print"},{"value":"1540-8183","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,4]]}}}