Open AccessUse of a Reperfusion Cannula for Acute Limb Ischemia in a Patient with Carotid Artery Extracorporeal Membrane Oxygenation Cannulation
Author(s) -
Raphael H. Parrado,
Monika F. Cardona,
Charles Garred,
Frederick Tecklenburg,
Ravi K. Veeraswamy,
Aaron Lesher,
Alice Walz
Publication year - 2021
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000001405
Subject(s) - medicine , extracorporeal membrane oxygenation , cannula , femoral artery , ischemia , thrombus , percutaneous , limb ischemia , anesthesia , catheter , surgery , population , cardiology , environmental health
Acute limb ischemia is a rare but potentially devastating event in a critically ill patient. In the pediatric population, limb ischemia is usually related to iatrogenic vascular damage and arterial thrombus formation secondary to arterial catheter placement. Children who have undergone femoral artery cannulation for venoarterial extracorporeal membrane oxygenation (VA-ECMO) are particularly at risk for this complication. In these cases, there have been reports of the successful use of a percutaneous limb reperfusion cannula to prevent or treat limb ischemia. We present a case of an 18 month old female who required VA-ECMO via carotid artery cannulation for viral myocarditis and subsequently developed acute lower limb ischemia related to a thrombus from an indwelling femoral arterial catheter in place for hemodynamic monitoring. This case highlights the usage of a distal reperfusion cannula and extracorporeal membrane oxygenation (ECMO) circuit for a novel purpose, which coupled with near infrared spectroscopy (NIRS) monitoring successfully re-established blood flow to the ischemic limb.