{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:40:20Z","timestamp":1791045620417,"version":"4.1.0"},"reference-count":9,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2014,5,2]],"date-time":"2014-05-02T00:00:00Z","timestamp":1398988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2014,11]]},"abstract":"Abstract<\/jats:title>Extracorporeal membrane oxygenation (ECMO<\/jats:styled-content>) is a temporary mechanical circulatory assist method that offers circulatory as well as respiratory support efficiently via peripheral access; however, it is liable to complications. Limb ischemia is one of the notorious complications of ECMO but can be avoided utilizing a proper distal limb perfusion method. A retrospective study of patients undergoing peripheral venoarterial (VA<\/jats:styled-content>) ECMO<\/jats:styled-content> for various reasons between June 2010 and December 2012 was performed. All patients were evaluated by our multidisciplinary team for suitability as candidates for ECMO<\/jats:styled-content>. A peripheral VA<\/jats:styled-content>\u2010ECMO<\/jats:styled-content> circuit was implanted via groin: inflow cannula in the femoral vein, an outflow cannula and distal\u2010perfusion cannula, or an introducer sheath in the femoral artery. During the study period, 83 patients underwent various types of ECMO<\/jats:styled-content>; 45 received peripheral VA<\/jats:styled-content>\u2010ECMO<\/jats:styled-content>. Distal limb perfusion was achieved with an introducer sheath (6\u20138\u2009Fr) in 13 cases and with a distal\u2010perfusion cannula (10\u201312\u2009Fr) in 32 cases. Nine (20%) patients developed signs of ischemia; five (11.2%) were treated conservatively, while four (8.8%) required surgical intervention. One patient required a below\u2010knee amputation. The incidences of limb ischemia and limb ischemia requiring surgical intervention were significantly higher for the introducer sheath compared with the cannula (30.6 vs. 15.6% and 15.4 vs. 6.25%, respectively). Moreover, the patients supported on ECMO<\/jats:styled-content> with a distal\u2010perfusion cannula spent a significantly longer time on ECMO<\/jats:styled-content> compared with the ones in whom an introducer sheath was used (11.9\u2009\u00b1\u20099.1 vs. 7.7\u2009\u00b1\u20094.3 days). The mean cannula size was significantly greater than the mean introducer sheath size (11.1\u2009\u00b1\u20091.3 vs. 7.0\u2009\u00b1\u20091.1\u2009Fr<\/jats:styled-content>). Use of a distal\u2010perfusion cannula is a most reliable method of limb perfusion in peripheral VA<\/jats:styled-content>\u2010ECMO<\/jats:styled-content>. The cannula can ensure adequate and smooth perfusion of the limb owing to its large caliber, its less turbulent flow, the ability it provides to monitor the flow, and the option to attach a side port.<\/jats:p>","DOI":"10.1111\/aor.12314","type":"journal-article","created":{"date-parts":[[2014,5,2]],"date-time":"2014-05-02T05:42:42Z","timestamp":1399009362000},"page":"940-944","source":"Crossref","is-referenced-by-count":53,"title":["Distal Limb Perfusion: Achilles' Heel in Peripheral Venoarterial Extracorporeal Membrane Oxygenation"],"prefix":"10.1111","volume":"38","author":[{"given":"Prashant N.","family":"Mohite","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javid","family":"Fatullayev","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Maunz","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundip","family":"Kaul","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Sabashnikov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Weymann","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana G.","family":"Saez","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil P.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bartlomiej","family":"Zych","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron F.","family":"Popov","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"DeRobertis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toufan","family":"Bahrami","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Amrani","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre R.","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Transplantation & Mechanical Support Harefield Hospital Royal Brompton & Harefield NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.01.085"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.08.025"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.07.083"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-6-164"},{"key":"e_1_2_7_6_1","first-page":"172","article-title":"A meta\u2010analysis of complications and mortality of extracorporeal membrane oxygenation","volume":"15","author":"Zangrillo A","year":"2013","journal-title":"Crit Care Resusc"},{"key":"e_1_2_7_7_1","unstructured":"Medtronic.Bio\u2010Medicus Femoral Venous and Arterial Cannulae. Available at:http:\/\/www.medtronic.com\/mics\/cannulae\u2010bio\u2010medicus\u2010femoral.html. Accessed February 06 2014."},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f2681"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31816f7cf7"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12267"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faor.12314","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.12314","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T12:19:40Z","timestamp":1695471580000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.12314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,2]]},"references-count":9,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2014,11]]}},"alternative-id":["10.1111\/aor.12314"],"URL":"https:\/\/doi.org\/10.1111\/aor.12314","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,2]]}}}