American Society of Hirudotherapy

Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5

Research article published in Artificial organs (2022)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Research reportDrug DevelopmentBashline M et al. · Artificial organs, 2022

Abstract

BACKGROUND: Impella 5.5 (Abiomed; Danvers, MA) (IMP5) is a commonly used, surgically implanted, tMCS device that requires systemic anticoagulation and purge solution to avoid pump failure. To avoid heparin-induced thrombocytopenia (HIT) from unfractionated heparin (UFH) use, our program has explored the utility of bivalirudin (BIV) for systemic anticoagulation and sodium bicarbonate-dextrose purge solution (SBPS) in IMP5.5. METHODS: This single center, retrospective study included 34 patients supported on IMP5.5 with BIV based AC and SBPS between December 1st 2020 to December 1st 2021.The efficacy and safety end points were incidence of development of HIT, Tissue Plasminogen Activator (tPA) use for suspected pump thrombosis, stroke, and device failure as well as clinically significant bleeding. RESULTS: The median duration of IMP5.5 support was 9.8 days (IQR: 6-15). Most patients were bridged to HTX (58%) followed by recovery (27%) and LVAD implantation (15%). Patients were therapeutic on bivalirudin for 64% of their IMP5.5 support. One patient (2.9%) suffered from ischemic stroke and 26.5% (9) patients developed clinically significant bleeding. tPA was administered to 7(21%) patients. One patient in the entire cohort developed HIT. CONCLUSIONS: Our experience supports the use of systemic BIV and SBPS as a method to avoid heparin exposure in a patient population predisposed to the development of HIT.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal Article
Indexed MeSH termsHumansHeparinAnticoagulantsTissue Plasminogen ActivatorSodium BicarbonateRetrospective StudiesHirudinsPeptide FragmentsHemorrhageThrombocytopeniaRecombinant ProteinsTreatment Outcome

Summary

Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5.

Why This Matters for Hirudotherapy

This single-center retrospective study evaluated 34 patients supported on Impella 5.5 who received systemic bivalirudin anticoagulation and sodium bicarbonate–dextrose purge solution to avoid heparin-induced thrombocytopenia (HIT). Outcomes included one ischemic stroke (2.9%), clinically significant bleeding in 26.5%, tPA administration for suspected pump thrombosis in 21%, and one new HIT case, with patients therapeutic on bivalirudin 64% of support time. For ASH, no defensible leech or hirudotherapy connection exists from the abstract: it does not mention leeches, hirudin, or leech-derived therapy. Honest caveat: this is a retrospective, single-center, uncontrolled study involving no leeches or leech therapy, and cannot establish comparative efficacy.

Citation

Outcomes of systemic bivalirudin and sodium bicarbonate purge solution for Impella 5.5

Bashline M et al. · Artificial organs, 2022

DOI

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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