A local complication-prevention pathway for Impella-supported cardiogenic shock: a single-center experience - Report - MDSpire

A Pathway for Preventing Local Complications in Impella-Associated Cardiogenic Shock: Insights from a Single-Center Study

  • By

  • Kenji Kanenawa

  • Akihiro Isotani

  • Kento Matsui

  • Keisuke Miyamoto

  • Katsunori Miyahara

  • Norihito Oyanagi

  • Kengo Korai

  • Toshinari Kaku

  • Shinichi Tsumaru

  • Takehiko Matsuo

  • Norimasa Matsuda

  • Shinichi Kakumoto

  • Takenori Domei

  • Makoto Hyodo

  • Shinichi Shirai

  • Kenji Ando

  • Koh Ono

  • July 17, 2026

Share

Clinical Report: Preventing Local Complications in Impella-Associated Cardiogenic Shock

Background

Cardiogenic shock is associated with high mortality rates and can lead to device-related complications when using mechanical circulatory support. The study highlights the importance of a structured approach to care transitions to minimize risks associated with Impella devices.

Data Highlights

PeriodType 3 Bleeding (%)Renal Replacement Therapy (%)30-Day Mortality (%)
Before Introduction35.653.449.3
Transition Period12.040.032.0
Full Implementation11.133.322.2

Key Findings

  • Type 3 bleeding decreased from 35.6% to 11.1% across the study periods.
  • Renal replacement therapy usage decreased from 53.4% to 33.3%.
  • 30-day mortality rates improved from 49.3% to 22.2%.
  • Standardized practices included reassessing systemic and lower-limb perfusion before leaving the catheterization lab.
  • Routine plasma-free hemoglobin surveillance was implemented to monitor hemolysis.
  • A shared checklist culture was emphasized to enhance safety during care transitions.

Clinical Implications

The findings suggest that implementing a structured complication-prevention pathway can significantly reduce device-related complications and mortality in patients receiving Impella support. Healthcare providers should consider standardizing practices to enhance patient safety during transitions of care.

Conclusion

The study underscores the importance of a systematic approach to managing patients with cardiogenic shock on Impella support, highlighting that safety may depend as much on care processes as on the device itself.

Related Resources & Content

  1. Clinical Research in Cardiology, 2023 -- Impact of Combined VAV-ECMO, Impella CP, and Impella RP on Hemodynamics
  2. Clinical Research in Cardiology, 2020 -- Evaluation of Mechanical Circulatory Support: A Propensity-Matched Study of Venoarterial Extracorporeal Membrane Oxygenation versus Impella in Patients Experiencing Cardiogenic Shock
  3. Clinical Research in Cardiology, 2026 -- Timing of IABP initiation and its impact on outcomes in acute myocardial infarction with cardiogenic shock: insights from a bi-center retrospective study
  4. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes
  5. Clinical Research in Cardiology — Enhanced Microcirculation in Acute ST-Elevation Myocardial Infarction Patients Receiving the Impella LP2.5 Percutaneous Left Ventricular Assist Device
  6. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines
  7. Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock | New England Journal of Medicine
  8. MI2AMI-CS: A meta-analysis comparing Impella and IABP outcomes in Acute Myocardial Infarction-related Cardiogenic Shock - ScienceDirect

Original Source(s)

A local complication-prevention pathway for Impella-supported cardiogenic shock: a single-center experience

  • by Kenji Kanenawa, Akihiro Isotani, Kento Matsui, Keisuke Miyamoto, Katsunori Miyahara, Norihito Oyanagi, Kengo Korai, Toshinari Kaku, Shinichi Tsumaru, Takehiko Matsuo, Norimasa Matsuda, Shinichi Kakumoto, Takenori Domei, Makoto Hyodo, Shinichi Shirai, Kenji Ando, Koh Ono

  • July 17, 2026

Related Content

Case Report: Sequential leadless pacing after battery depletion in a patient with recurrent device-related infection

Predictive value of the serum sodium to log(D-dimer) ratio for the risk of all-cause death in patients with chronic heart failure with different ejection fractions

Case Report: A rare stop-gained MYZAP mutation is associated with atrioventricular septal defects in an Arabian family