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Preparation and technical considerations for percutaneous cannulation for veno-arterial extracorporeal membrane oxygenation

J Card Surg. 2013 Mar;28(2):190-2. doi: 10.1111/jocs.12058. Epub 2013 Feb 5.

Abstract

Background: The most frequent limb complications from peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done.

Technique: Percutaneous cannulation with a distal perfusion port was performed in all patients. During the VA-ECMO, distal limb perfusion was monitored using near-infrared spectroscopy to assess tissue oxygenation. At the decannulation, patch angioplasty was performed to prevent the development of narrowing of the artery at the cannulation site.

Conclusions: Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding.

MeSH terms

  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / methods*
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / instrumentation
  • Extracorporeal Membrane Oxygenation / methods*
  • Femoral Vein
  • Humans
  • Intraoperative Complications / prevention & control*
  • Ischemia / etiology
  • Ischemia / prevention & control*
  • Leg / blood supply*