Q: The right common carotid artery has been used for cannulation for VA ECMO (Extracorporeal membrane oxygenation) in patients with severe peripheral arterial disease. What is the highest risk involved with this approach? 


 Answer: 5 to 10 percent risk of a clinically significant watershed cerebral infarction. In situations where femoral access is not viable, experts recommend the subclavian approach. But again, clinical situation precedes any decision.


 Reference: 

Navia JL, Atik FA, Beyer EA, Ruda Vega P. Extracorporeal membrane oxygenation with right axillary artery perfusion. Ann Thorac Surg 2005; 79:2163.