NYMC Faculty Publications

Practical Approach to Confirm Femoral Artery Patency After Percutaneous Closure for Veno-Arterial Extracorporeal Membrane Oxygenation Decannulation

Author Type(s)

Student, Faculty, Resident/Fellow

DOI

10.1177/02676591231220820

Journal Title

Perfusion United Kingdom

First Page

1545

Last Page

1548

Document Type

Article

Publication Date

11-1-2024

Department

Surgery

Second Department

Medicine

Keywords

arterial cannula, decannulation, ECMO, percutaneous closure

Disciplines

Medicine and Health Sciences

Abstract

Background: We describe a technique to assess blood flow distal to the decannulation site after deployment of Perclose ProGlide (Abbott Vascular, Abbott Park, Ill) in patients on femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support. Technique: An antegrade distal perfusion catheter was placed in all patients, and decannulation was primarily performed at bedside (N = 11/12). With the VA-ECMO circuit switched off, a needle was inserted into the arterial tubing, passed through the femoral arterial cannula into the artery. The arterial cannula was removed over a wire and the previously placed Proglide Perclose sutures were secured. Back bleeding from the antegrade distal perfusion catheter, confirmed using a three-way connector, indicated blood flow to the superficial femoral artery. This was followed by confirmation of blood flow to the lower leg using a Doppler ultrasound. Hemostasis of the antegrade perfusion catheter was achieved through manual compression. Results: We implemented this technique in 12 patients with a technical success rate of 100%. There were no ipsilateral leg ischemia, bleeding, pseudoaneurysm, or infection after decannulation. Conclusions: This technique allows prompt assessment of blood flow to the distal leg immediately following arterial decannulation.

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