Journal of Artificial Organs

, Volume 8, Issue 3, pp 206–209 | Cite as

Perfusion through the dorsalis pedis artery for acute limb ischemia secondary to an occlusive arterial cannula during percutaneous cardiopulmonary support

  • Naoyuki Kimura
  • Koji Kawahito
  • Satoshi Ito
  • Seiichiro Murata
  • Atushi Yamaguchi
  • Hideo Adachi
  • Takashi Ino
CASE REPORT

Abstract

Percutaneous cardiopulmonary support (PCPS) is a powerful resuscitation tool for patients in cardiogenic shock. The femoral artery is generally used for arterial access; however, vascular complications, particularly in atherosclerotic arteries, can occur. Although such complications occur infrequently, they can be fatal. We describe the case of a 75-year-old woman who required extended PCPS for cardiogenic shock secondary to coronary spasm after on-pump beating coronary artery bypass grafting. Limb ischemia occurred because of an occlusive cannula, and distal perfusion with a 20G elastic intravenous catheter inserted into the dorsalis pedis artery resolved the ischemia. The catheter was connected to the side port of an oxygenator and provided distal limb perfusion during PCPS. This technique appears to be useful in treating limb ischemia and may have application in patients with arterial occlusive disease who are dependent on mechanical support.

Key words

PCPS Limb ischemia Dorsalis pedis artery 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kawahito, K, Ino, T, Adachi, H, Ide, H, Mizuhara, A, Yamaguchi, A 1994Heparin-coated percutaneous cardiopulmonary support for the treatment of circulatory collapse after cardiac surgeryASAIO J40972976Google Scholar
  2. 2.
    Kawahito, K, Murata, S, Adachi, H, Ino, T, Fuse, K 2000Resuscitation and circulatory support using extracorporeal membrane oxygenation for fulminant pulmonary embolismArtif Organs24427430Google Scholar
  3. 3.
    Kawahito, K, Murata, S, Yasu, T, Adachi, H, Ino, T, Saito, M, Misawa, Y, Fuse, K, Shimada, K 1998Usefulness of extracorporeal membrane oxygenation for treatment of fulminant myocarditis and circulatory collapseAm J Cardiol82910911Google Scholar
  4. 4.
    Sakai, M, Ohteki, H, Doi, K, Masumoto, A, Akatsuka, H, Hayashida, K, Narita, Y 1996Clinical application and indications for percutaneous cardiopulmonary bypass support in cardiopulmonary failure of various etiologiesJ Jpn Soc Intens Care Med7345351Google Scholar
  5. 5.
    Muehrcke, DD, McCarthy, PM, Stewart, RW, Seshagiri, S, Ogella, DA, Foster, RC, Cosgrove, DM 1995Complications of extracorporeal life support systems using heparin-bound surfaces. The risk of intracardiac clot formationJ Thorac Cardiovasc Surg110843851Google Scholar
  6. 6.
    Funk, M, Ford, CF, Foell, DW, Bonini, S, Sexton, DL, Ostfeld, AM, Cabin, HS 1992Frequency of long-term lower limb ischemia associated with intraaortic balloon pump useAm J Cardiol7011951199Google Scholar
  7. 7.
    Greason, KL, Hemp, JR, Maxwell, JM, Fetter, JE, Moreno-Cabral, RJ 1995Prevention of distal limb ischemia during cardiopulmonary support via femoral cannulationAnn Thorac Surg60209210Google Scholar
  8. 8.
    Hata, M, Shiono, M, Orime, Y, Yagi, SY, Yamamoto, T, Okumura, H, Kimura, SI, Nakata, KI, Kashiwazaki, S, Choh, S, Negishi, N, Sezai, Y 2000Strategy of circulatory support with percutaneous cardiopulmonary supportArtif Organs24636639Google Scholar
  9. 9.
    Strandness, DE 1975Hemodynamics for surgeonsGrune and StrattonNew York209211Google Scholar
  10. 10.
    Berceli, SA, Chan, AK, Pomposelli, FB,Jr, Gibbons, GW, Campbell, DR, Akbari, CM, Brophy, DT, LoGerfo, FW 1999Efficacy of dorsal pedal artery bypass in limb salvage for ischemic heel ulcersJ Vasc Surg30499508Google Scholar
  11. 11.
    Pomposelli, FB,Jr, Marcaccio, EJ, Gibbons, GW, Campbell, DR, Freeman, DV, Burgess, AM, Miller, A, LoGerfo, FW 1995Dorsalis pedis arterial bypass: durable limb salvage for foot ischemia in patients with diabetes mellitusJ Vasc Surg21375384Google Scholar
  12. 12.
    Tannenbaum, GA, Pomposelli, FB,Jr, Marcaccio, EJ, Gibbons, GW, Campbell, DR, Freeman, DV, Miller, A, LoGerfo, FW 1992Safety of vein bypass grafting to the dorsal pedal artery in diabetic patients with foot infectionsJ Vasc Surg15982990Google Scholar

Copyright information

© The Japanese Society for Artificial Organs 2005

Authors and Affiliations

  • Naoyuki Kimura
    • 1
  • Koji Kawahito
    • 1
  • Satoshi Ito
    • 1
  • Seiichiro Murata
    • 2
  • Atushi Yamaguchi
    • 2
  • Hideo Adachi
    • 2
  • Takashi Ino
    • 2
  1. 1.Department of Cardiovascular SurgeryItabashi Chuo Medical CenterTokyoJapan
  2. 2.Department of Cardiovascular Surgery, Jichi Medical SchoolOmiya Medical CenterSaitamaJapan

Personalised recommendations