Sidakpal Panaich, MBBS, clinical assistant professor in Cardiovascular Medicine, led the team of specialists who completed the state of Iowa’s first high-risk percutaneous coronary intervention while inserting an Impella device via a blood vessel close to the shoulder. An Impella is a mechanical support device often used to support heart function during high-risk percutaneous (minimally invasive) procedures. For patients with severe peripheral arterial disease, the femoral access typically used for Impella is inaccessible.

“This device provides mechanical support to the heart during either cardiogenic shock or high risk percutaneous coronary stenting procedures. This provides us with alternative access in patients with peripheral arterial disease,” Panaich said. “It will also provide better mobility in heart failure patients who need long-term mechanical support since they are able to sit up and be relatively more mobile as compared to femoral access Impella where they have to lay flat for the entire duration.”

The success of this procedure opens doors to alternative axillary intervention for more patients. “It allows all other physicians to refer their patients with confidence that we will be able to perform high-risk procedures with adequate mechanical support even if they have peripheral arterial disease,” Panaich said.

The procedure team included University of Iowa’s cardiovascular fellows Musab Alqasrawi, MBBS, and Abdul Qazi, MBBS, as well as James Rossen, MD, interventional cardiologist in University of Iowa Health Care, and Raj Tayal, MD, MPH, from Newark Beth Israel Medical Center, who supplied the images below.