{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:06:07Z","timestamp":1785575167462,"version":"3.56.0"},"reference-count":18,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,6,21]],"date-time":"2016-06-21T00:00:00Z","timestamp":1466467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Interven Cardiology"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>We compared the ischemia and rescue rates according to the strategy of distal cannulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Limb ischemia developing during percutaneous venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is a potentially severe complication. Although appropriate use of a distal perfusion cannula can avoid ischemia, evidences about distal cannulation is still lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent peripheral VA ECMO between January 2010 and August 2015 were reviewed. We classified patients into 2 groups in terms of insertion timing with respect to the onset of ischemia. The preemptive strategy group underwent early insertion of a distal perfusion cannula at commencement of ECMO support. The rescue strategy group underwent delayed cannula insertion after onset of limb ischemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 151 patients were included in the analysis. Forty\u2010four patients formed the preemptive strategy group and 107 patients formed the rescue strategy group. In total, 10 of 151 (6.7%) patients developed significant limb ischemia, they all were the rescue strategy group (10\/107, 9.3%). Of the 10 patients, 2 patients were rescued from limb ischemia after distal cannulation. Otherwise, ischemia was not rescued in the remaining eight patients. Of the latter 8, 3 patient required surgical interventions (2 fasciotomy and 1 below\u2010the\u2010knee amputation) and the other five died from disease aggravation prior to surgical intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preemptive distal perfusion cannulation is safe and effective when used to prevent lower limb ischemia in patients undergoing femoral cannulation to treat ECMO. However, delayed distal cannulation increases the extent of cannulation site bleeding, without improving the ischemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joic.12309","type":"journal-article","created":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T03:53:28Z","timestamp":1466654008000},"page":"431-436","source":"Crossref","is-referenced-by-count":44,"title":["The Utility of Preemptive Distal Perfusion Cannulation During Peripheral Venoarterial Extracorporeal Membrane Oxygenation Support"],"prefix":"10.1111","volume":"29","author":[{"given":"Hye Ju","family":"Yeo","sequence":"first","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Hoon","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doosoo","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Seong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woo Hyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dohyung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pulmonary, Allergy and Critical Care Medicine, Pusan National University Yangsan Hospital, The Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital Yangsan Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.12.014"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.09.008"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00302-6"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(96)00772-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1532\/HSF98.2014364"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2006.00201.x"},{"key":"e_1_2_9_8_1","unstructured":"ELSO general guidelines for all ECLS cases. version 1.3 (2013 November) available 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