{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:30:00Z","timestamp":1740180600287,"version":"3.37.3"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["CVIR Endovasc"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Current guidelines recommend the use of mechanical circulatory support (MCS) for patients with cardiogenic shock that is refractory to medical therapy. Bleeding is the most common complication of MCS. Transarterial embolization (TAE) is often performed to treat this complication, because it is a less invasive hemostatic procedure. However, the TAE option needs to be carefully considered during MCS, as the access route may be limited during MCS.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A man in his 70\u00a0s was diagnosed with acute myocardial infarction and underwent percutaneous coronary intervention via venoarterial extracorporeal membrane oxygenation (VA-ECMO) and Impella. During treatment in the intensive care unit, he suffered damage to a branch of the internal thoracic artery during a cardiac drainage procedure, which was subsequently treated via emergency TAE.<\/jats:p>\n                <jats:p>An ECMO return cannula and an Impella sheath were inserted into the patient\u2019s right and left femoral arteries, respectively. An approach from the left brachial artery was selected, and the left internal thoracic artery was embolized. Subsequently, the patient required re-intervention to treat re-bleeding from another artery. Because it was difficult to target the target artery from the brachial one, owing to interference from the Impella catheter, the ECMO circuit near the return cannula was punctured and a guiding sheath was inserted. The ECMO flow and the patient\u2019s blood pressure decreased following placement of this guiding sheath. We were thus able to maintain the patient\u2019s blood pressure by increasing the infusion fluids and Impella flow, and embolize the target artery using a gelatin sponge to achieve hemostasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>When TAE is difficult to perform during MCS using an approach from the upper extremities, a lower extremity approach with a sheath inserted into the ECMO circuit may represent a viable alternative.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s42155-024-00460-8","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T01:02:28Z","timestamp":1716253348000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transarterial embolization to treat a massive hemothorax during mechanical circulatory support via puncturing of the extracorporeal membrane oxygenation circuit"],"prefix":"10.1186","volume":"7","author":[{"given":"Ryota","family":"Tsushima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8465-6274","authenticated-orcid":false,"given":"Takaaki","family":"Maruhashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaro","family":"Kurihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiro","family":"Hashikata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasushi","family":"Asari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"460_CR1","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.amjcard.2022.06.059","volume":"181","author":"K Bhatia","year":"2022","unstructured":"Bhatia K, Jain V, Hendrickson MJ, Aggarwal D, Aguilar-Gallardo JS, Lopez PD, et al. Meta-analysis comparing venoarterial extracorporeal membrane oxygenation with or without Impella in patients with cardiogenic Shock. Am J Cardiol. 2022;181:94\u2013101.","journal-title":"Am J Cardiol"},{"key":"460_CR2","doi-asserted-by":"publisher","first-page":"1503","DOI":"10.31083\/j.rcm2204154","volume":"22","author":"F Fiorelli","year":"2021","unstructured":"Fiorelli F, Panoulas V. Impella as unloading strategy during VA-ECMO: systematic review and meta-analysis. Rev Cardiovasc Med. 2021;22:1503\u201311.","journal-title":"Rev Cardiovasc Med"},{"key":"460_CR3","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.carrev.2021.10.001","volume":"40","author":"M Iannaccone","year":"2022","unstructured":"Iannaccone M, Venuti G, Simone DE, Filippo DO, Bertaina M, Colangelo S, et al. Comparison of ECMO vs ECpella in patients with non-post-pericardiotomy cardiogenic shock: an updated meta-analysis. Cardiovasc Revasc Med. 2022;40:134\u201341.","journal-title":"Cardiovasc Revasc Med"},{"key":"460_CR4","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","volume":"42","author":"TA McDonagh","year":"2021","unstructured":"McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, B\u00f6hm M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599\u2013726.","journal-title":"Eur Heart J"},{"key":"460_CR5","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.1161\/CIR.0000000000001076","volume":"146","author":"BJ Geller","year":"2022","unstructured":"Geller BJ, Sinha SS, Kapur NK, Bakitas M, Balsam LB, Chikwe J, et al. Escalating and de-escalating temporary mechanical circulatory support in cardiogenic shock: a scientific statement from the American Heart Association. Circulation. 2022;146:e50-68.","journal-title":"Circulation"},{"key":"460_CR6","first-page":"5348835","volume":"2022","author":"TP Nguyen","year":"2022","unstructured":"Nguyen TP, Phan XT, Nguyen TH, Huynh DQ, Tran LT, Pham HM, et al. Major bleeding in adults undergoing peripheral extracorporeal membrane oxygenation (ECMO): Prognosis and predictors. Crit Care Res Pract. 2022;2022:5348835.","journal-title":"Crit Care Res Pract"},{"key":"460_CR7","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1001\/jama.2020.0254","volume":"323","author":"SS Dhruva","year":"2020","unstructured":"Dhruva SS, Ross JS, Mortazavi BJ, Hurley NC, Krumholz HM, Curtis JP, et al. Association of use of an intravascular microaxial left ventricular assist device vs intra-aortic balloon pump with in-hospital mortality and major bleeding among patients with acute myocardial infarction complicated by cardiogenic shock. JAMA. 2020;323:734\u201345.","journal-title":"JAMA"},{"key":"460_CR8","first-page":"358","volume":"9","author":"L Cappannoli","year":"2023","unstructured":"Cappannoli L, Galli M, Zito A, Restivo A, Princi G, Laborante R, et al. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) with vs without left ventricular unloading by Impella: a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2023;9:358\u201366.","journal-title":"Eur Heart J Qual Care Clin Outcomes."},{"key":"460_CR9","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1093\/ehjacc\/zuad149","volume":"13","author":"T Nasu","year":"2024","unstructured":"Nasu T, Ninomiya R, Koeda Y, Morino Y. Impella device in fulminant myocarditis: Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events. Eur Heart J Acute Cardiovasc Care. 2024;13:275\u201383.","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"460_CR10","first-page":"136","volume":"8","author":"K Goto","year":"2023","unstructured":"Goto K, Takayama Y, Honda G, Fujita K, Osame A, Urakawa H, et al. Risk factors for bleeding in coronavirus disease 2019 patients on extracorporeal membrane oxygenation and effects of transcatheter arterial embolization for hemostasis. Interv Radiol (Higashimatsuyama). 2023;8:136\u201345.","journal-title":"Interv Radiol (Higashimatsuyama)"},{"key":"460_CR11","doi-asserted-by":"publisher","first-page":"e67","DOI":"10.1016\/j.jcin.2019.11.038","volume":"13","author":"DS Sulimov","year":"2020","unstructured":"Sulimov DS, Meyer A, Thiele H, Abdel-Wahab M. Rescue peripheral intervention using a peripheral ECMO-cannula as vascular access. JACC Cardiovasc Interv. 2020;13:e67\u20138.","journal-title":"JACC Cardiovasc Interv"},{"key":"460_CR12","first-page":"121","volume":"37","author":"N Eiji","year":"2010","unstructured":"Eiji N, Emi F, Takahiro M, Kazuhiro O. Evaluation of the access management into the artery for re-infusion of PCPS circuit in patient with out-of-hospital cardiopulmonary arrest. J Extra Corporeal Technol. 2010;37:121\u20133.","journal-title":"J Extra Corporeal Technol"}],"container-title":["CVIR Endovascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-024-00460-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42155-024-00460-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42155-024-00460-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T01:02:32Z","timestamp":1716253352000},"score":1,"resource":{"primary":{"URL":"https:\/\/CVIRendovasc.springeropen.com\/articles\/10.1186\/s42155-024-00460-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,21]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["460"],"URL":"https:\/\/doi.org\/10.1186\/s42155-024-00460-8","relation":{},"ISSN":["2520-8934"],"issn-type":[{"type":"electronic","value":"2520-8934"}],"subject":[],"published":{"date-parts":[[2024,5,21]]},"assertion":[{"value":"19 February 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors. All procedures were performed in accordance with the ethical standards of the institutional and\/or national research committee, as well as the 1964 Declaration of Helsinki and its later amendments, or comparable ethical standards. The patient has given written informed consent for this publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"48"}}