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

CP won't advance

IVL cracks calcium

CP advances easily
