Axillary Artery Thrombosis After LVAD Explantation Managed With Thrombectomy and Stenting.

BACKGROUND

Left ventricular assist devices are increasingly used for circulatory support in patients with cardiogenic shock or severe left ventricular dysfunction. However, their use is associated with complications, most notably vascular complications.

CASE SUMMARY: We report the case of a 63-year-old woman who developed a right axillary artery thrombus following removal of an Impella 5.5 left ventricular assist device after recovering from cardiogenic shock. The patient underwent emergent mechanical thrombectomy and percutaneous transluminal angioplasty with stent placement, successfully restoring arterial patency. A hypercoagulability work-up revealed a heterozygous prothrombin G20210A mutation.

DISCUSSION: This case highlights a rare but serious complication of axillary Impella placement, emphasizing the importance of early detection and intervention for vascular complications.

TAKE-HOME MESSAGES: Preprocedural vessel assessment and vigilant monitoring are key to detecting complications in axillary Impella support. Refining techniques will help maintain this access route as a safe long-term option.