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Ex‐vivo percutaneous bypass: Limb perfusion in the setting of occlusive large bore sheath
Author(s) -
Shah Zeel,
Alraies M. Chadi,
Soud Mohamad,
Kaki Amir
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28022
Subject(s) - medicine , cardiogenic shock , limb perfusion , perfusion , percutaneous , cardiac catheterization , cardiology , limb ischemia , angiography , hemodynamics , ex vivo , cardiopulmonary bypass , ischemia , surgery , myocardial infarction , in vivo , microbiology and biotechnology , biology
Successful cardiac catheterization procedure begins with safe vascular access and ends with effective hemostasis after equipment removal. These new and advanced technologies in the cath lab require large‐bore arterial accesses. Large‐bore sheaths are associated with blood flow obstruction resulting in limb ischemia. In this case we present a 48‐year‐old woman was admitted NSTEMI and cardiogenic shock requiring mechanical circulatory support. Selective left common iliac angiography demonstrated obstructive flow at the level of the left CFA (access site). Therefore, ipsilateral bypass circuit was done. The current case illustrates the utility of a temporary ex‐vivo bypass circuit to preserve limb perfusion in the presence of an occlusive large bore sheath. The technique permits sufficient hemodynamic support while maintaining limb perfusion and can be used for any occlusive large bore sheath.