Access & Closure, Impella Education
Impella® Skills Video: Single-Access Technique for Impella CP® and Impella CP® with SmartAssist®
This Impella skills video describes the single-access technique for Impella CP and Impella CP with SmartAssist. The single-access technique provides an option for patients with limited vascular access.
Using the Impella CP 14Fr introducer sheath for percutaneous coronary intervention (PCI) access decreases the number of access sites, potentially reducing complications related to multiple access sites. For the single-access technique, Abiomed recommends up to a 7Fr secondary introducer. An 8Fr sheath or larger does not allow for the guide catheter to pass easily alongside the Impella catheter and should not be used for the single-access technique.
The single-access technique can be employed after successful placement and support with Impella CP or Impella CP with SmartAssist. After placing the Impella 14Fr peel-away sheath using ultrasound and micropuncture access best practices, continue with the following procedural steps:
- Aspirate and flush the Impella 14Fr sheath.
- Place a micropuncture or 18-gauge needle into the diaphragm of the 14Fr peel-away sheath at the 10 o’clock or 2 o’clock position for placement of the 0.035” guidewire. Avoid the center of the diaphragm where the Impella catheter goes through the hemostatic valve or bleeding may occur.
- Secure the Impella catheter to avoid any movement and insert the PCI sheath over the 0.035” guidewire.
- Perform the PCI procedure.
- Remove the PCI sheath at the end of the procedure while securing the Impella catheter.