Left Subclavian IABP

Romick

Left subclavian iabp

if left subclavian is occluded or otherwise inaccessible procedure is aborted. Iabp should not be inserted through right subclavian per ct surgery.

equipment

• micropuncture
• (2) 4/5f slender radial sheath
• amplatz extra stiff 260cm wire
• .035 150cm jwire
• 5f pigtail catheter
• 5f jr4 diagnostic catheter
• iabp kit
• 8f 23cm safesheath (ep)
• perclose
• tr band

procedure

• prep left side neck and chest (ear to nipple and shoulder to midline)
  • note: the access site is not an absolute (may become axillary or subclavicular) hence the large site prep.

• prep left radial
• left radial accessed and 4/5f slender sheath inserted
• pigtail advanced and angiogram performed. Pigtail left in place and used as reference for subclavian access.
• subclavian accessed with ultrasound and fluoro guidance using micropuncture kit and radial sheath inserted.
• pigtail catheter removed
• j wire and jr4 inserted and directed to descending aorta.
• catheter and sheath removed, 8f dilator inserted, and perclose advanced for pre-closure
• amplatz wire advanced, perclose removed, 8f safe sheath advanced.
• iabp inserted
• sheath peeled away
• iabp secured with suture and site dressed.
• radial sheath removed and tr band applied

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Approved: md initials mm/yy