{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:10:17Z","timestamp":1771233017752,"version":"3.50.1"},"reference-count":10,"publisher":"Texas Heart Institute Journal","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:p>Many patients who are in cardiogenic shock need mechanical support for clinical stabilization after acute insults such as myocardial infarction. However, the placement of advanced devices can be hindered by anatomic constraints or the physiologic sequelae of shock, as we describe in this report.<\/jats:p>\n        <jats:p>A 67-year-old woman with prior coronary artery bypass grafting and extensive chest-wall scarring from previous defibrillator implantations presented with myocardial infarction and refractory cardiogenic shock. The patient's vascular anatomy and prior surgery precluded conventional percutaneous implantation of an Impella 5.0 ventricular support device. We delivered the Impella device through the patient's tortuous, vasoconstricted axillary artery with use of a vascular sheath and other percutaneous techniques. The success of this approach suggests that combining the expertise of cardiologists and cardiovascular surgeons can improve the outcomes of patients with complex anatomic issues.<\/jats:p>","DOI":"10.14503\/thij-14-4337","type":"journal-article","created":{"date-parts":[[2015,8,3]],"date-time":"2015-08-03T13:22:06Z","timestamp":1438608126000},"page":"385-388","source":"Crossref","is-referenced-by-count":2,"title":["Use of a Vascular Sheath in the Axillary Artery as an Alternative Access Approach for Placing an Impella 5.0 Device"],"prefix":"10.14503","volume":"42","author":[{"given":"Ankur S.","family":"Shah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn S.","family":"Hui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert H.","family":"Neumayr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua M.","family":"Stolker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"19","key":"i0730-2347-42-4-385-b1","series-title":"J Am Coll Cardiol","first-page":"1584","article-title":"A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction","volume":"52","year":"2008","unstructured":"Seyfarth\n              M, \n            \n              Sibbing\n              D, \n            \n              Bauer\n              I, \n            \n              Frohlich\n              G, \n            \n              Bott-Flugel\n              L, \n            \n              Byrne\n              R, \n          \n          et al. A randomized clinical trial to evaluate the safety and efficacy of a percutaneous left ventricular assist device versus intra-aortic balloon pumping for treatment of cardiogenic shock caused by myocardial infarction. J Am Coll Cardiol2008;52(19):1584\u20138."},{"issue":"2","key":"i0730-2347-42-4-385-b2","series-title":"JACC Cardiovasc Interv","first-page":"91","article-title":"A prospective feasibility trial investigating the use of the Impella 2.5 system in patients undergoing high-risk percutaneous coronary intervention (The PROTECT I Trial): initial U.S. experience","volume":"2","year":"2009","unstructured":"Dixon\n              SR, \n            \n              Henriques\n              JP, \n            \n              Mauri\n              L, \n            \n              Sjauw\n              K, \n            \n              Civitello\n              A, \n            \n              Kar\n              B, \n          \n          et al. A prospective feasibility trial investigating the use of the Impella 2.5 system in patients undergoing high-risk percutaneous coronary intervention (The PROTECT I Trial): initial U.S. experience. JACC Cardiovasc Interv2009;2(2):91\u20136."},{"issue":"14","key":"i0730-2347-42-4-385-b3","series-title":"Circulation","first-page":"1717","article-title":"A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study","volume":"126","year":"2012","unstructured":"O'Neill\n              WW, \n            \n              Kleiman\n              NS, \n            \n              Moses\n              J, \n            \n              Henriques\n              JP, \n            \n              Dixon\n              S, \n            \n              Massaro\n              J, \n          \n          et al. A prospective, randomized clinical trial of hemodynamic support with Impella 2.5 versus intra-aortic balloon pump in patients undergoing high-risk percutaneous coronary intervention: the PROTECT II study. Circulation2012;126(14):1717\u201327."},{"issue":"14","key":"i0730-2347-42-4-385-b4","series-title":"N Engl J Med","first-page":"1287","article-title":"Intraaortic balloon support for myocardial infarction with cardiogenic shock","volume":"367","year":"2012","unstructured":"Thiele\n              H, \n            \n              Zeymer\n              U, \n            \n              Neumann\n              FJ, \n            \n              Ferenc\n              M, \n            \n              Olbrich\n              HG, \n            \n              Hausleiter\n              J, \n          \n          et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med2012;367 (14):1287\u201396."},{"issue":"4","key":"i0730-2347-42-4-385-b5","series-title":"Ann Thorac Surg","first-page":"1468","article-title":"The right axillary artery approach for the Impella Recover LP 5.0 microaxial pump","volume":"85","year":"2008","unstructured":"Sassard\n              T, \n            \n              Scalabre\n              A, \n            \n              Bonnefoy\n              E, \n            \n              Sanchez\n              I, \n            \n              Farhat\n              F, \n            \n              Jegaden\n              O.\n            \n          \n          The right axillary artery approach for the Impella Recover LP 5.0 microaxial pump. Ann Thorac Surg2008;85 (4):1468\u201370."},{"key":"i0730-2347-42-4-385-b6","article-title":"Abiomed Product Manuals [Internet]","unstructured":"Abiomed Product Manuals [Internet]. Available at: http:\/\/www.abiomed.com\/products\/product-manuals [cited 2013 Dec 4]."},{"issue":"2","key":"i0730-2347-42-4-385-b7","series-title":"Catheter Cardiovasc Interv","first-page":"163","article-title":"Intra-aortic balloon pump placement following aorto-iliac angioplasty and stent placement","volume":"55","year":"2002","unstructured":"Colyer\n              WR\n              Jr\n            , BurketMW, AnselGM, RameeSR, MinorRL, GibsonCM, CooperCJ.\n          Intra-aortic balloon pump placement following aorto-iliac angioplasty and stent placement. Catheter Cardiovasc Interv2002;55(2):163\u20138."},{"issue":"3","key":"i0730-2347-42-4-385-b8","series-title":"Acute Card Care","first-page":"146","article-title":"Temporary (short-term) percutaneous left ventricular assist device (Tandem-Heart) in a patient with STEMI, multivessel coronary artery disease, cardiogenic shock and severe peripheral artery disease","volume":"11","year":"2009","unstructured":"Neuzil\n              P, \n            \n              Kmonicek\n              P, \n            \n              Skoda\n              J, \n            \n              Reddy\n              VY.\n            \n          \n          Temporary (short-term) percutaneous left ventricular assist device (Tandem-Heart) in a patient with STEMI, multivessel coronary artery disease, cardiogenic shock and severe peripheral artery disease. Acute Card Care2009;11(3):146\u201350."},{"issue":"11","key":"i0730-2347-42-4-385-b9","series-title":"J Invasive Cardiol","first-page":"E254","article-title":"GuideLiner catheter facilitated PCI--a novel device with multiple applications","volume":"23","year":"2011","unstructured":"Pershad\n              A, \n            \n              Sein\n              V, \n            \n              Laufer\n              N.\n            \n          \n          GuideLiner catheter facilitated PCI--a novel device with multiple applications. 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