SAICR-CTO: Single Access Impella-Guided Complete Revascularization in Chronic Total Occlusion-A Novel Approach to High-Risk PCI.

The Impella is a ventricular assist device (VAD) that provides circulatory assistance to patients with impaired heart function during percutaneous coronary intervention (PCI). It ejects blood from the left ventricle directly into the aorta. Although most cases of Impella-assisted PCI are done using two access ports, the single access technique was described by Jason Wollmuth et al. An inherent drawback of multiple access is the heightened susceptibility to vascular complications like thrombosis, hematoma, pseudoaneurysm, and retroperitoneal bleeding. Single access for high-risk PCI (SHiP) reduces complications from PCI access and is useful in patients with limited arterial access. This study presents a case of extension of SHiP technique used in a case of complex high-risk intervention and CTO with dual access using an Impella single-access sheath.