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. 2022 Jul 4;5(4):e709. doi: 10.1002/hsr2.709

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© 2022 The Authors. Health Science Reports published by Wiley Periodicals LLC.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Procedural steps after Impella‐protected percutaneous coronary intervention with preimplantation of two suture devices (ProGlide or ProStyle). (A) After Impella pump removal, 0.35′ guidewire insertion into Impella sheath. (B) The Impella sheath is removed and the node pushers are used to gently tighten the two sutures. (C) A diagnostic JR4 4F is advanced over the 0.35′ guidewire into the femoral artery reaching the descending aorta. (D) The 0.35′ guidewire is removed from the JR4 4F catheter and the catheter is connected to the injector. (E) Digital subtraction is performed to assess arterial integrity. (F) The 0.35′ guidewire is inserted into the 4F catheter to avoid kinking. Then the 0.35′ guidewire/4F catheter system is removed, and the device's node pushers are used to tighten the sutures in order to complete hemostasis.