The use of temporary percutaneous mechanical circulatory support (MCS) devices for cardiogenic shock (CS) and high-risk percutaneous coronary intervention (HRPCI) is increasing in the United States . Most MCS devices require large-bore access for insertion with sheath sizes often upward of 14 Fr, making them prone to access-site complications such as hematoma, bleeding, pseudoaneurysm, and limb ischemia. In particular, bleeding with use of large-bore access is associated with worse outcomes including longer length and higher costs of hospital stay, and higher mortality . Thus, it is necessary to implement meticulous insertion and removal techniques for these MCS devices to minimize complications and related adverse outcomes.