Contraindications and complications
As with other mechanical support devices, severe peripheral vascular
disease is a relative contraindication for femoral access due to the
risk of limb ischaemia. The presence of a mechanical aortic valve is
considered an absolute contraindication, while severe aortic stenosis as
a relative contraindication [8].
Potential complications related to the use of Impella are
device-related, peripheral vascular and distal thrombus formation with
subsequent strokes. According to a recent report, the most common
complications reported were bleeding requiring transfusion (17.5%),
vascular access complications (15.2%), infection (12.9%), haemolysis
(10.3%), vascular complications with a need of surgical repair (9.7%),
limb ischaemia (3.9%) and bleeding requiring surgical intervention
(2.6%) [8, 13]. Valvular complications included aortic and mitral
valve injury or regurgitation.