Optimal Large-Bore Vascular Access and Closure for Percutaneous Mechanical Circulatory Support in Cardiogenic Shock.

Bleeding and vascular injuries are common and serious adverse consequences of large-bore arterial and venous access. Optimal vascular access, indwelling device management, device removal, and arteriotomy and venotomy closure protocols are essential for safe and effective use of percutaneous mechanical circulatory support devices for cardiogenic shock. Ongoing innovations in best-practices, vascular safety bundles, and sheath and device design, hemocompatibility, performance, and miniaturization are expected to further improve device safety and efficacy-and cardiogenic shock patient outcomes-in the future.