Mechanical external compression devices to manage bleeding during mechanical circulatory support with Impella CP

BackgroundIn recent years, there has been a significant increase in the use of mechanical circulatory support devices, including the Impella device (Abiomed, Danvers, MA, USA), as hemodynamic support during high-risk percutaneous coronary intervention (PCI) and in acute management of cardiogenic shock.ResultsIn this case series, we present two patients with non-ST-elevation myocardial infarction complicated by cardiogenic shock treated with Impella CP-protected PCI. After the revascularization, for both patients, a clinically relevant, access-site bleeding occurred, challenging the Impella CP maintenance. However, hemostasis was successfully achieved with a mechanical external compression device, allowing Impella hemodynamic support to continue.Major findingsIn this case series we propose a novel and easy approach to manage access-site bleeding while using the Impella catheter.