| A simple technique to prevent limb ischemia during veno-arterial ecmo using the femoral artery: the posterior tibial approach. | |
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MedLine Citation:
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PMID: 22143092 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Lower extremity ischemia is common when the femoral artery is used for veno-arterial extracorporeal membrane oxygenation (VA ECMO). We describe a new technique to reperfuse the extremity. The ipsilateral posterior tibial artery is exposed via a small incision behind the medial malleolus. The vessel is cannulated in a retrograde fashion and connected to the arterial limb of the ECMO circuit.Thirty-six patients received a posterior tibial reperfusion cannula: average flow was 155.8 ml/min and increased over the initial 24 hours. Fifty-eight percent received the posterior tibial cannula within 6 hours of ECMO initiation and none sustained permanent lower extremity injury. Of the remaining 42%, three required amputation or developed permanent neurologic injury. Overall survival was 41%.Cannulation of the posterior tibial artery is a simple technique to reperfuse the lower extremity during VA ECMO. The cannula should be inserted within 6 hours of ECMO initiation to avoid irreversible ischemic damage. |
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Authors:
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D J Spurlock; J M Toomasian; M A Romano; E Cooley; R H Bartlett; J W Haft |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-5 |
Journal Detail:
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Title: Perfusion Volume: - ISSN: 1477-111X ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8700166 Medline TA: Perfusion Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Surgery, University of Michigan Health System University of Michigan, Ann Arbor, MI, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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