Abstract
Vascular access to systemic circulation is the key point for ECMO institution. In the pioneering years, the surgical approach was the rule both for central and peripheral cannulation in V-A or V-V ECMO. In the early 1990s, the availability of new thin-walled spring-wired reinforced cannulas opened the era of percutaneous cannulation technique, which shortly became the first choice for ECMO peripheral cannulation. Benefits of percutaneous cannulation versus the surgical technique are a reduced procedural time, decreased bleeding complications, and easy decannulation without the need of vessel repair. Percutaneous placement of cannulas can be done at any bedside in the hospital, intensive care unit, emergency room, and catheterization laboratory or intraoperatively. We will review cannula implantation and explantation techniques for V-V and V-A ECMO and discuss the vascular complications that can ensue during and after the procedure and their possible solutions.
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Migliari, M., Marcolin, R., Avalli, L., Bombino, M. (2014). Percutaneous Cannulation: Indication, Technique, and Complications. In: Sangalli, F., Patroniti, N., Pesenti, A. (eds) ECMO-Extracorporeal Life Support in Adults. Springer, Milano. https://doi.org/10.1007/978-88-470-5427-1_4
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DOI: https://doi.org/10.1007/978-88-470-5427-1_4
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