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Peer-reviewedCC BY-NC-ND 4.0Journal of the Society for Cardiovascular Angiography & Interventions

Optimal Sheath for Single-Access Percutaneous Coronary Intervention With Impella CP Hemodynamic Support

  • Ravi Thakker1
  • Adnan Khalif2
  • Ying Xu3
  • Seth Bilazarian3
  • Dana Bentley3
  • J. Dawn Abbott4
  • Mario Iannaccone5
  • Jason Wollmuth6
  • William O’Neill7
  • Alexander G. Truesdell8
  • Hady Lichaa9
  • Mir Babar Basir7
9 affiliations
  1. 1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
  2. 2Allegheny Health Network Cardiovascular Institute, Pittsburgh, Pennsylvania
  3. 3Abiomed – Johnson & Johnson, Inc., Danvers, Massachusetts
  4. 4Lifespan Cardiovascular Institute and Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, Rhode Island
  5. 5S.G. Bosco Hospital, ASL Citta di Torino, Turin, Italy
  6. 6Providence Heart and Vascular Institute, Providence, Oregon
  7. 7Division of Cardiovascular Diseases, Henry Ford Hospital, Detroit, Michigan
  8. 8Division of Cardiology, Virginia Heart and Inova Schar Heart and Vascular, Fairfax, Virginia
  9. 9Division of Cardiology, Ascension St Thomas Heart, Nashville, Tennessee
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Abstract

Background: Single-access percutaneous coronary intervention (PCI) with the Impella CP (Abiomed) has increased in prevalence. Despite this, the optimal PCI sheath remains unknown. We characterized the optimal 7F PCI sheath using the single-access technique.

Methods: The outer diameter measurement of the sheaths was performed using a Keyence 2-axis laser micrometer (Keyence). The force needed to insert the sheath and the torqueability of the guide catheter were assessed using the Mark-10 M5i Advanced Digital Force/Torque Indicator (Mark-10 Corporation) on a simulated single-access setting in a simulated skin pad. The sample size was determined to be 5 sheaths for each test.

Results: The BRITE TIP 11 cm (Cordis), BRITE TIP 35 cm (Cordis), and Destination sheath (Terumo) had the largest outer diameters; the Prelude IDeal (Merit Medical) and Terumo Glidesheath (Terumo) had the smallest outer diameters. The Glidesheath was easiest for insertion/removal, followed by the Prelude IDeal and Impella Low Profile (LP) Companion sheath (Abiomed). The Impella LP Companion, Prelude Roadster (Merit Medical), and Destination sheaths allowed for the best torqueability and lowest force to remove the guide catheter. The longer Impella LP Companion sheath did not impact torqueability, but the removal force increased by 50% compared with the shorter Impella LP Companion sheath.

Conclusion: The Impella LP Companion sheath demonstrated the best torqueability and least effort in advancing the guide catheters, while the Prelude Roadster and Destination also performed well on these metrics. The Prelude IDeal and Glidesheath were good options for single-access because of their smaller outer diameters and hydrophilic coating and were easiest for insertion/removal through the 14F LP sheath.

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Cite

BibTeXRIS
BibTeX
@article{thakker2026optimal,
  title = {{Optimal Sheath for Single-Access Percutaneous Coronary Intervention With Impella CP Hemodynamic Support}},
  author = {Ravi Thakker and Adnan Khalif and Ying Xu and Seth Bilazarian and Dana Bentley and J. Dawn Abbott and Mario Iannaccone and Jason Wollmuth and William O’Neill and Alexander G. Truesdell and Hady Lichaa and Mir Babar Basir},
  journal = {Journal of the Society for Cardiovascular Angiography \& Interventions},
  year = {2026},
  month = jul,
  doi = {10.1016/j.jscai.2026.105519},
  url = {https://doi.org/10.1016/j.jscai.2026.105519},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Optimal Sheath for Single-Access Percutaneous Coronary Intervention With Impella CP Hemodynamic Support
AU  - Ravi Thakker
AU  - Adnan Khalif
AU  - Ying Xu
AU  - Seth Bilazarian
AU  - Dana Bentley
AU  - J. Dawn Abbott
AU  - Mario Iannaccone
AU  - Jason Wollmuth
AU  - William O’Neill
AU  - Alexander G. Truesdell
AU  - Hady Lichaa
AU  - Mir Babar Basir
PY  - 2026
DA  - 2026/07/30
JO  - Journal of the Society for Cardiovascular Angiography & Interventions
DO  - 10.1016/j.jscai.2026.105519
UR  - https://doi.org/10.1016/j.jscai.2026.105519
AB  - Background: Single-access percutaneous coronary intervention (PCI) with the Impella CP (Abiomed) has increased in prevalence. Despite this, the optimal PCI sheath remains unknown. We characterized the optimal 7F PCI sheath using the single-access technique.  Methods: The outer diameter measurement of the sheaths was performed using a Keyence 2-axis laser micrometer (Keyence). The force needed to insert the sheath and the torqueability of the guide catheter were assessed using the Mark-10 M5i Advanced Digital Force/Torque Indicator (Mark-10 Corporation) on a simulated single-access setting in a simulated skin pad. The sample size was determined to be 5 sheaths for each test.  Results: The BRITE TIP 11 cm (Cordis), BRITE TIP 35 cm (Cordis), and Destination sheath (Terumo) had the largest outer diameters; the Prelude IDeal (Merit Medical) and Terumo Glidesheath (Terumo) had the smallest outer diameters. The Glidesheath was easiest for insertion/removal, followed by the Prelude IDeal and Impella Low Profile (LP) Companion sheath (Abiomed). The Impella LP Companion, Prelude Roadster (Merit Medical), and Destination sheaths allowed for the best torqueability and lowest force to remove the guide catheter. The longer Impella LP Companion sheath did not impact torqueability, but the removal force increased by 50% compared with the shorter Impella LP Companion sheath.  Conclusion: The Impella LP Companion sheath demonstrated the best torqueability and least effort in advancing the guide catheters, while the Prelude Roadster and Destination also performed well on these metrics. The Prelude IDeal and Glidesheath were good options for single-access because of their smaller outer diameters and hydrophilic coating and were easiest for insertion/removal through the 14F LP sheath.
SN  - 2772-9303
ER  -