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Percutaneous Cannulation: Indication, Technique, and Complications

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ECMO-Extracorporeal Life Support in Adults

Abstract

Vascular access to systemic circulation is the key point for ECMO institution. In the pioneering years, the surgical approach was the rule both for central and peripheral cannulation in V-A or V-V ECMO. In the early 1990s, the availability of new thin-walled spring-wired reinforced cannulas opened the era of percutaneous cannulation technique, which shortly became the first choice for ECMO peripheral cannulation. Benefits of percutaneous cannulation versus the surgical technique are a reduced procedural time, decreased bleeding complications, and easy decannulation without the need of vessel repair. Percutaneous placement of cannulas can be done at any bedside in the hospital, intensive care unit, emergency room, and catheterization laboratory or intraoperatively. We will review cannula implantation and explantation techniques for V-V and V-A ECMO and discuss the vascular complications that can ensue during and after the procedure and their possible solutions.

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Author information

Authors and Affiliations

  1. Cardiac Anesthesia and Intensive Care Unit, Department of Emergency Medicine, San Gerardo Hospital, Via Pergolesi 33, Monza, (MB), 20900, Italy

    Maurizio Migliari

  2. General Intensive Care Unit, Department of Emergency Medicine, San Gerardo Hospital, Via Pergolesi 33, Monza, (MB), 20900, Italy

    Roberto Marcolin & Michela Bombino

  3. Cardiac Anesthesia and Intensive Care Unit, Department of Urgency and Emergency, San Gerardo Hospital, Via Pergolesi 33, Monza, (MB), 20900, Italy

    Leonello Avalli

Authors
  1. Maurizio Migliari
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  2. Roberto Marcolin
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  3. Leonello Avalli
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  4. Michela Bombino
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Corresponding author

Correspondence to Maurizio Migliari .

Editor information

Editors and Affiliations

  1. Department of Anaesthesia and Intensive Care Medicine, San Gerardo Hospital, Monza (MB), Italy

    Fabio Sangalli

  2. Department of Health Sciences Medicine, University of Milano-Bicocca, San Gerardo Hospital, Monza (MB), Italy

    Nicolò Patroniti

  3. Health Science Departement, Università Milano Bicocca Facoltà Medicina e Chirurgia, Monza (MB), Italy

    Antonio Pesenti

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Migliari, M., Marcolin, R., Avalli, L., Bombino, M. (2014). Percutaneous Cannulation: Indication, Technique, and Complications. In: Sangalli, F., Patroniti, N., Pesenti, A. (eds) ECMO-Extracorporeal Life Support in Adults. Springer, Milano. https://doi.org/10.1007/978-88-470-5427-1_4

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  • DOI: https://doi.org/10.1007/978-88-470-5427-1_4

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  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5426-4

  • Online ISBN: 978-88-470-5427-1

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