title: Perfusion through the dorsalis pedis artery for acute limb ischemia secondary to an occlusive arterial cannula during percutaneous cardiopulmonary support.
abstract: Percutaneous cardiopulmonary support (PCPS) is a powerful resuscitation tool for patients in cardiogenic shock. The femoral artery is generally used for arterial access; however, vascular complications, particularly in atherosclerotic arteries, can occur. Although such complications occur infrequently, they can be fatal. We describe the case of a 75-year-old woman who required extended PCPS for cardiogenic shock secondary to coronary spasm after on-pump beating coronary artery bypass grafting. Limb ischemia occurred because of an occlusive cannula, and distal perfusion with a 20G elastic intravenous catheter inserted into the dorsalis pedis artery resolved the ischemia. The catheter was connected to the side port of an oxygenator and provided distal limb perfusion during PCPS. This technique appears to be useful in treating limb ischemia and may have application in patients with arterial occlusive disease who are dependent on mechanical support.
authors.affiliation: Department of Cardiovascular Surgery, Itabashi Chuo Medical Center, 2-12-7 Azusawa, Itabashi-ku, Tokyo, 174-0051, Japan. kimura-n@omiya.jichi.ac.jp
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kimura
authors.forename: Koji
authors.initials: K
authors.lastname: Kawahito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ito
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Murata
authors.forename: Atushi
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Adachi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ino
mesh_terms: D000208:Acute Disease; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D010477:Perfusion; D012770:Shock, Cardiogenic / Q000628:therapy