Transfemoral Impella in Calcified Iliacs

Robert Riley, MD, The Christ Hospital
Baseline angiogram shows extensive iliofemoral calcification in cardiogenic shock patient. Transfemoral delivery of Impella CP attempted, but device won’t advance. Shockwave IVL delivered to iliac artery to fracture calcium. Post-IVL, Impella device advances smoothly through iliac artery.
Baseline Angio — Calcification
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CP won't advance
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IVL cracks calcium
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CP advances easily
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