A novel percutaneous solution to limb ischemia due to arterial occlusion from a femoral artery ECMO cannula

To describe a novel percutaneous technique for distal limb perfusion in the face of femoral artery occlusion secondary to extracorporeal membrane oxygenation (ECMO) cannula placement. The technique is described in a 59-year-old man who presented with an inferior wall myocardial infarction and a larg...

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Bibliographic Details
Published in:Journal of endovascular therapy 2010-02, Vol.17 (1), p.51-54
Main Authors: Rao, Atul S, Pellegrini, Ronald V, Speziali, Giovanni, Marone, Luke K
Format: Article
Language:English
Subjects:
Arterial Occlusive Diseases - diagnostic imaging
Arterial Occlusive Diseases - etiology
Arterial Occlusive Diseases - therapy
Catheterization, Peripheral - adverse effects
Catheterization, Peripheral - instrumentation
Catheters
Extracorporeal Membrane Oxygenation - adverse effects
Extracorporeal Membrane Oxygenation - instrumentation
Femoral Artery - diagnostic imaging
Heart Septal Defects, Ventricular - complications
Heart Septal Defects, Ventricular - surgery
Humans
Inferior Wall Myocardial Infarction - complications
Inferior Wall Myocardial Infarction - therapy
Ischemia - diagnostic imaging
Ischemia - etiology
Ischemia - therapy
Lower Extremity - blood supply
Male
Medical imaging
Middle Aged
Radiography
Regional Blood Flow
Treatment Outcome
Veins & arteries
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Summary:To describe a novel percutaneous technique for distal limb perfusion in the face of femoral artery occlusion secondary to extracorporeal membrane oxygenation (ECMO) cannula placement. The technique is described in a 59-year-old man who presented with an inferior wall myocardial infarction and a large ventricular septal defect (VSD) requiring the initiation of ECMO via right femoral artery and vein cannulae. He subsequently developed right lower limb ischemia secondary to cannula occlusion of the femoral artery. Percutaneous transfemoral placement of a flush catheter in the right common femoral artery was performed angiographically. Ischemic symptoms resolved, and the patient was subsequently able to undergo repair of his VSD without any further lower limb ischemic sequelae. Percutaneous transfemoral placement of a flush catheter in the common femoral artery distal to ECMO cannula insertion has not to our knowledge been reported and carries the added benefit of restoring perfusion to both superficial and profunda femoris arteries.
ISSN:1526-6028
1545-1550
DOI:10.1583/09-2845.1