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Intensive Care Medicine

, Volume 44, Issue 5, pp 658–660 | Cite as

Fast confirmation of correct position of distal perfusion cannula during venoarterial extracorporeal membrane oxygenation

  • J. J. H. Bunge
  • E. A. F. Mahtab
  • K. Caliskan
  • D. Reis MirandaEmail author
Open Access
Imaging in Intensive Care Medicine

Lower extremity ischemia is a serious complication in patients treated with venoarterial extracorporeal membrane oxygenation (vaECMO). The Extracorporeal Life Support Organization (ELSO) database reports a 5% incidence of ischemic leg complications, leading to leg amputation in 1% of the vaECMO runs. Pacing a distal perfusion catheter (DPC) in the superficial femoral artery and confirming correct placement are essential.

We present a patient with primary graft dysfunction after heart transplantation. vaECMO was instituted surgically in the right femoral artery and vein with an ipsilateral 6 Fr, 24 cm DPC (CL-07624, Arrow, Athlone, Ireland) in the common femoral artery. As a result of multiple percutaneous coronary interventions in the past, visual confirmation of the correct placement of the DPC was difficult during surgery. Postoperatively, no Doppler flow could be measured in the popliteal artery. We inserted a “J”-tipped guidewire (0.81 mm, 60 cm, CS-25855, Arrow, Athlone, Ireland) into the DPC and visualized the wire in the popliteal artery using ultrasound (Figs. 1, 2, video in the ESM), confirming the right position.
Fig. 1

Popliteal artery and vein in short-axis view, just cranial of the popliteal space. Guidewire not yet visible in the artery

Fig. 2

Popliteal artery in long-axis view just cranial of the popliteal space, while the guidewire is passing through the artery

Notes

Compliance with ethical standards

Conflicts of interest

D. Reis Miranda has received speaking fees from Xenios GmbH and HillRom. The other authors have no conflicts of interest to declare.

Supplementary material

Supplementary material 1 (MOV 19,295 kb)

Copyright information

© The Author(s) 2018

Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  1. 1.Department of Intensive Care AdultsErasmus University Medical CentreRotterdamThe Netherlands
  2. 2.Department of CardiologyErasmus University Medical CentreRotterdamThe Netherlands
  3. 3.Department of Cardio-thoracic SurgeryErasmus University Medical CentreRotterdamThe Netherlands

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