Suspected Lower Extremity Ischemia After End-to-Side Femoral

J. Cardiothorac. Vasc. Anesth. · Jun 2021

Case Reports

Suspected Lower Extremity Ischemia After End-to-Side Femoral Arterial Grafting for VA-ECMO.

Lower extremity ischemic complications are frequently encountered after femoral cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO). Many are attributed to mechanical obstruction of distal arterial blood flow related to intraluminal positioning of the arterial cannula. ⋯ Side- arm grafting instead of direct arterial cannulation is suggested as an alternative. Here, the authors present a case wherein a patient developed suspected lower extremity ischemia from hyperperfusion after femoral VA-ECMO cannulation during use of an arterial side- arm graft, calling into question the benefits of this cannulation strategy.

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- Elliott L Woodward, Tao Shen, and James G Ramsay.
- Department of Anesthesia, UCSF Medical Center, San Francisco, CA. Electronic address: elliott.woodward@ucsf.edu.
- J. Cardiothorac. Vasc. Anesth. 2021 Jun 1; 35 (6): 1824-1829.
AbstractLower extremity ischemic complications are frequently encountered after femoral cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO). Many are attributed to mechanical obstruction of distal arterial blood flow related to intraluminal positioning of the arterial cannula. Routine use of distal perfusion catheters is ineffective at eliminating the development of these serious complications. Side- arm grafting instead of direct arterial cannulation is suggested as an alternative. Here, the authors present a case wherein a patient developed suspected lower extremity ischemia from hyperperfusion after femoral VA-ECMO cannulation during use of an arterial side- arm graft, calling into question the benefits of this cannulation strategy.Copyright © 2020 Elsevier Inc. All rights reserved.

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Suspected Lower Extremity Ischemia After End-to-Side Femoral Arterial Grafting for VA-ECMO.

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