A Novel Femoral Arterial Cannula to Prevent Limb Ischemia During Cardiopulmonary Support: Preliminary Report of Experimental and Clinical Experiences

Abstract

Distal limb ischemia may occur as a serious complication related to the use of femoral cannulation during veno-arterial cardiopulmonary support (CPS). We developed a simple cannula for femoral arterial cannulation with two holes in the side wall, which could provide the distal limb blood flow without additional cannulation or surgical procedure. This cannula can be inserted into the femoral artery by routine Seldinger technique. The distal blood flow from the side holes can be confirmed by Doppler detector without specialized techniques. In porcine experimental model, the distance between the position where the blood flow was first detected and those where the blood leakage took place was at least more than 10 mm. When this cannula and its side holes were adequately positioned, the mean distal limb flow ranged from 75 to 90 mL/min under CPS at a flow of 1.5 L/min. We employed this cannula for six patients in clinical settings. Three patients showed a good distal limb blood flow at the introduction position without its adjustment. The other three patients showed distal limb ischemia at the introduction position, but the limb ischemia was soon recovered after a slight adjustment of its position. There was no blood leakage from the percutaneous entry into the artery in all cases. We currently use this cannula as the first choice for patients undergoing a prolonged CPS.

Limb ischemia during femoral cannulation for cardiopulmonary support

“…A novel arterial cannula with side holes to allow for distal limb perfusion has also been described. 9 Prophylactic antegrade SFA cannulation to prevent ipsilateral limb ischemia may be considered or even become the standard of care at some centers. However, this technique, at least in our institution, is felt to mandate surgical cutdown and cannula placement in patients who are often not fit for transport, much less a visit to the operating room.…”

Comparison of femoral and auricular arterial blood pressure monitoring in pigs

“…The femoral artery has been catheterized via a Seldinger technique with commercially available catheters (Fudge et al. 2002; Matsuri et al. 2006), commercial intravenous over‐the‐needle catheters (Gaymes et al.…”

“…The femoral artery has been catheterized via a Seldinger technique with commercially available catheters (Fudge et al 2002;Matsuri et al 2006), commercial intravenous over-the-needle catheters (Gaymes et al 1995), and surgical approaches with semi rigid tubing (Waynforth et al 2003), fed within the artery. A surgical approach is the more common.…”

Artificial Organs 2006: A Year in Review

“…Yoshiro Matsui et al. (44) of the Ikegami General Hospital Heart Center (Tokyo, Japan) developed a cannula for femoral arterial cannulation with side holes to provide distal limb blood flow during venoarterial cardiopulmonary support. Of six patients studied, good distal limb blood flow was seen on introduction, while in the three others, adjustment of its position was required.…”