Treffalls, Rebecca

Introduction Lower Extremity Extracorporeal Distal Revascularization (LEEDR) is a novel, preclinically tested technique designed to provide temporary limb perfusion in cases of acute limb ischemia when immediate revascularization is not feasible. Methods LEEDR employs an extracorporeal pump and circuit to draw arterial blood from a proximal inflow site and deliver it to an outflow artery within the ischemic limb. The system is designed for bedside initiation using percutaneous access. Results ALI from embolism, thrombosis, or trauma rapidly leads to irreversible tissue damage. Delays in revascularization are associated with high rates of limb loss and systemic complications. LEEDR offers a time-sensitive intervention aimed at mitigating these risks and preserving limb viability until definitive treatment is available. Conclusion LEEDR is a promising temporary perfusion strategy for limb salvage in ALI. This manuscript outlines its procedural components, technical considerations, and anticipated role in bridging patients to definitive revascularization.

Objectives Traditionally, acute mesenteric ischemia studies are performed by utilizing an open superior mesenteric artery (SMA) occlusion, which is an invasive technique with potentially devastating effects. A new endovascular technique for SMA occlusion using a catheter-balloon system was designed and compared to the open SMA occlusion to test its efficacy and animal safety. Methods All animals underwent open instrumentation of the superior mesenteric vein (SMV) for blood flow monitoring. The animals were grouped into an open SMA occlusion technique group and an endovascular SMA occlusion group. The open SMA occlusion technique group involved exposure of the SMA via left medial visceral rotation with vascular clamping. In the endovascular group, an endovascular balloon was placed in the SMA and inflated to produce occlusion. Results Complete cessation of flow to the SMV was observed in the endovascular group, compared to the residual SMV flow in the open occlusion group. Following a 30-min post-occlusion period, the MAP in the endovascular group increased, compared to a decline of MAP in the open occlusion group. Conclusions This study indicates the endovascular technique provides a more potent SMA occlusion, with insignificant consequences on the overall health of the animal, in contrast to the open vascular clamping.