Ultrasound-Measured Femoral Arterial/Venous Parameters for Guiding Extracorporeal Membrane Oxygenation (ECMO) Catheterization

2021 ◽  
Vol 11 (8) ◽  
pp. 2253-2257
Author(s):  
Hao Zhou ◽  
Yong Mei ◽  
Jinru Lv ◽  
Wei Li ◽  
Gang Zhang ◽  
...  

The femoral artery/vein are commonly used for vascular access in clinical practice. The position, adjoining relationship, and anatomic variation of the femoral artery/vein may affect the success rate of catheterization. Clinically, we found a proportion of anatomic variations in the common position of the femoral artery catheterization. We intended to determine the positioning data of the femoral artery/vein to provide a partial clinical basis for catheterization by ultrasound. At the common femoral artery catheterization site, we used ultrasound to collect data on the femoral artery/vein of 208 samples. We found that the distance from the midpoint of the pubic symphysis to the surface position of the femoral artery, the distance between the central points of the femoral artery/vein, and the inner diameter of the femoral artery were significantly correlated with height, weight, and gender, and were not correlated with age, shock, hypertension, diabetes, and coronary heart disease. If branching of the femoral artery was higher than the inguinal ligament, the inner diameter of the femoral artery at the catheterization site was significantly reduced. We believe that height, weight, gender, and anatomic variation are important factors influencing the adjoining relationship and the inner diameter of the femoral artery. During extracorporeal membrane oxygenation (ECMO) catheterization, if an arterial branch is found at the femoral artery catheterization site, it is recommended to adjust the catheterization protocol.

2001 ◽  
Vol 27 (2) ◽  
pp. 181-188 ◽  
Author(s):  
Åsa Rydń Ahlgren ◽  
Håkan Åstrand ◽  
Thomas Sandgren ◽  
Einar Vernersson ◽  
Bjr̈n Sonesson ◽  
...  

2018 ◽  
Vol 21 (1) ◽  
pp. 018 ◽  
Author(s):  
Chih-Chien Yen ◽  
Chih-Hong Kao ◽  
Chien-Sung Tsai ◽  
Shin-Han Tsai

Objective: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain.Methods: This is a retrospective study. Data was reviewed for patients in one medical center who were supported by venoarterial extracorporeal membrane oxygenation (VA-ECMO) via CFA cannulation percutaneously between January 2008 and June 2014. Two groups were divided into no-ischemia and ischemic limb. Age, sex, height, weight, body surface area (BSA), cannula size, femoral artery diameter, comorbidity, acute physiology and chronic health evaluation (APACHE) II score, vasoactive-inotropic score (VIS) and mortality rate were analyzed. Doppler was used by measuring the distal pulsation in the dorsalis pedis and posterior tibial artery to select the patients. A DPC was prophylactically inserted percutaneously into the superficial femoral artery for antegrade flow to the extremity in the patients who met selection criteria.Results: 139 (43.6%) patients were included in the study and limb ischemia occurred in 46 (33%) of 139. There was a significant difference between the no-ischemia group and the ischemia group in age (55.5 ± 14.2 versus 63.2 ± 13.2; P < .001), common femoral artery diameter (0.82 ± 0.14 versus 0.63 ± 0.17; P < .001 ), known peripheral artery occlusive disease (9% versus 24%; P < .001) and VIS (12.1 ± 8.1 versus 15.8 ± 10.1; P < .001). Mortality rate was higher in the ischemia group (46% versus 26% ; P < .001). 11 patients who met the selection criteria had a DPC prophylactically inserted and no ischemia limb occurred.Conclusion: Smaller common femoral artery diameter (≤6.3 cm); known peripheral arterial occlusive disease; higher VIS (≥15.8); absence of distal pulsation pre-cannulation or immediately after post-cannulation or 4 hrs later have higher risk of limb ischemia when CFA cannulation is used for VA-ECMO. Due to this, the mortality and morbidity rate increases when limb ischemia occurs. A DPC should be prophylactically inserted in high-risk patients who meet selection criteria.


2015 ◽  
Vol 29 (8) ◽  
pp. 1493-1500 ◽  
Author(s):  
Romain de Blic ◽  
Jean-François Deux ◽  
Hicham Kobeiter ◽  
Pascal Desgranges ◽  
Jean-Pierre Becquemin ◽  
...  

2012 ◽  
Vol 28 (5) ◽  
pp. 264-267 ◽  
Author(s):  
C Lekich ◽  
W Campbell ◽  
S Walton ◽  
P Hannah

Objectives: To discuss safety of EVLA in anomalies of the GSV anatomy. To review and discuss complications of surgery involving anomalous anatomy. Method: We report a case of high bifurcation of the common femoral artery wrapping around the saphenofemoral junction. Results: Successful ablation was achieved with no adverse consequences. Conclusion: EVLA is a safe treatment for SFJ/GSV incompetence in the presence of vascular anomalies that have historically resulted in serious vascular complications from surgery.


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