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 li...

Chronic critical limb ischemia is defined as ischemia which generally endangers the distal part of a limb. If the ischemia is unrelenting, there is a high risk that amputation will be required. These critical limbs were amputated as an initial treatment long ago. Now it becomes clear that disabling patients have very poor quality of life after major amputation, and ischemic leg produces noxious...

BACKGROUND Some 40 000 lower limb amputations are performed in Germany each year, 70% of them in diabetics. About 80% of all major amputations may be preventable with the use of new interventional and vascular surgical procedures, particularly on the arteries of the leg and foot. We present the current state of the art in revascularization techniques and evaluate their usefulness for preservati...

Critical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced form of peripheral arterial disease. Traditionally, open surgical bypass was the only effective treatment strategy for limb revascularization in this patient population. However, during the past decade, the introduction and ...

Critical limb ischemia (CLI) continues to be a significantly morbid disease process for the aging population. Rigid guidelines for the management of patients with CLI are inappropriate due to the complexities that are involved in optimally treating these patients. A thin line exists in the decision process between medical management vs surgical management by revascularization or amputation, and...