Assessing potential for aortoiliac vascular injury from venoarterial extracorporeal membrane oxygenation cannulae

Haymet, A. B., Boone, A., Vallely, M. P., Malfertheiner, M. V., Pauls, J. P., Suen, J. Y., & Fraser, J. F. (2021). Assessing potential for aortoiliac vascular injury from venoarterial extracorporeal membrane oxygenation cannulae: An in vitro particle image velocimetry study. Artificial organs, 45(2), E14–E25. https://doi.org/10.1111/aor.13807

Abstract: Limb ischemia is a major complication associated with peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO). The high velocity jet from arterial cannulae can cause "sandblasting" injuries to the arterial endothelium, with the potential risk of distal embolization and end organ damage. The aim of this study was to identify, for a range of clinically relevant VA-ECMO cannulae and flow rates, any regions of peak flow velocity on the aortic wall which may predispose to vascular injury, and any regions of low-velocity flow which may predispose to thrombus formation. A silicone model of the aortic and iliac vessels was sourced and the right external iliac artery was cannulated. Cannulae ranged from 15 to 21 Fr in size.