# A Novel Technique to Prevent Femoral Artery Occlusion With Impella CP Sheaths: Case Report

## TL;DR

A new technique is described to prevent leg ischemia when using Impella CP in small femoral arteries.

## Contribution

A novel method using a parallel catheter to prevent femoral artery occlusion is introduced.

## Key findings

- A small catheter placed parallel to the Impella CP insertion site prevents total femoral artery occlusion.
- The technique was successfully used in a patient with cardiogenic shock following a heart attack.
- Antegrade access to the superficial femoral artery can be achieved using an adjacent wedge catheter if needed.

## Abstract

Impella CP use in small femoral arteries has increased vascular and ischemic complications. Various techniques have been described to lessen leg ischemia. Our technique uses a small catheter placed below the Impella CP insertion site and runs parallel with it to prevent total occlusion in the femoral artery. This could be a primary technique to try first. If more distal flow to the leg is needed, antegrade access to the superficial femoral artery can be obtained with connection to the adjacent wedge catheter. We describe this use for first time in a patient with cardiogenic shock after myocardial infarction with mitral regurgitation.