Preparation and technical considerations for percutaneous cannulation for veno-arterial extracorporeal membrane oxygenation.

BACKGROUND The most frequent limb complications from peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done. TECHNIQUE Percutaneous cannulation with a distal perfusion port was performed in all patients. During the VA-ECMO, distal limb perfusion was monitored using near-infrared spectroscopy to assess tissue oxygenation. At the decannulation, patch angioplasty was performed to prevent the development of narrowing of the artery at the cannulation site. CONCLUSIONS Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding.