Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
J Endovasc Ther. 2010 Feb;17(1):51-4. doi: 10.1583/09-2845.1.
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.
描述一种新的经皮技术,用于股动脉阻塞导致体外膜肺氧合(ECMO)插管放置后,远端肢体的灌注。
该技术在一名 59 岁男性中进行了描述,该男性患有下壁心肌梗死和大室间隔缺损(VSD),需要通过右股动脉和静脉插管启动 ECMO。随后,由于股动脉插管阻塞,他出现右下肢缺血。经股动脉顺行穿刺插入普通冲洗导管。缺血症状缓解,随后患者能够进行 VSD 修复,而没有任何进一步的下肢缺血后遗症。
据我们所知,经皮穿刺股动脉在 ECMO 插管插入部位远端插入普通冲洗导管尚未有报道,并且具有恢复股浅动脉和股深动脉灌注的额外益处。