Management of Femoral Large-Bore Access and Closure During Microaxial Flow Pump-Supported Interventions
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By
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Vergallo, Rocco
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Lombardi, Marco
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Macchione, Andrea
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Pescetelli, Fabio
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Benenati, Stefano
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Vercellino, Matteo
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Secco, Gioel Gabrio
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Gonzalo, Nieves
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Escaned, Javier
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Porto, Italo
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April 29, 2026
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Clinical Scorecard: Strategies for Managing Large-Bore Femoral Access and Closure in Microaxial Flow Pump-Assisted Procedures
At a Glance
| Category | Detail |
|---|
| Condition | Cardiogenic Shock and High-Risk Percutaneous Coronary Interventions |
| Key Mechanisms | Microaxial flow pump (mAFP) for hemodynamic assistance |
| Target Population | Patients undergoing HR-PCI and those with cardiogenic shock |
| Care Setting | Interventional cardiology |
Key Highlights
- Large-bore arterial access increases risk of vascular complications
- Ultrasound and angiography improve safety of femoral access
- Pre-closure methods are recommended for HR-PCI
- Post-closure methods are crucial for cardiogenic shock patients
- Efficient closure techniques can reduce morbidity and mortality
Guideline-Based Recommendations
Diagnosis
- Assess the need for mAFP in patients with CS and HR-PCI
Management
- Utilize ultrasound- and angiography-guided puncture for femoral access
- Implement pre-closure techniques for HR-PCI patients
Monitoring & Follow-up
- Monitor for vascular complications post-procedure
Risks
- Increased morbidity and mortality associated with vascular complications
Patient & Prescribing Data
Patients requiring mechanical circulatory support
Focus on secure vascular access and closure techniques
Clinical Best Practices
- Employ advanced imaging for safer femoral access
- Adopt a modern approach to femoral access and closure management
- Prioritize pre-closure in HR-PCI and post-closure in CS
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