Related Experiment Video
Updated: Jan 10, 2026

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Axillary VA-ECMO Implantation Under Regional Block Anesthesia
Thomas Lefebvre1, Guillaume Bayart1, Florent Briffa2
1Anesthesia and Critical Care Department, Amiens Hospital University, Amiens, France.
Background:
Axillary venoarterial extracorporeal membrane oxygenation (VA-ECMO) implantation for refractory cardiogenic shock traditionally requires general anesthesia, risking hemodynamic compromise in critically ill patients.
First-In-Human/Early Reports Summary:
We report the first-in-human axillary VA-ECMO cannulation via Dacron tube graft performed under locoregional anesthesia with sedation in a 58-year-old man with SCAI stage D cardiogenic shock. The procedure was successfully completed, with excellent patient tolerance, hemodynamic stability, and preserved neurologic monitoring throughout. The patient achieved successful ECMO weaning after 7 days, with preserved limb function and no cannulation-related complications through 30-day follow-up.
Discussion:
This novel approach avoided general anesthesia-related hemodynamic compromise while enabling continuous neurologic assessment. Subsequent patient mortality at 75 days resulted from unrelated device infections and was not attributable to the innovative cannulation technique.
Novelty:
This is the first reported axillary ECMO cannulation under regional anesthesia, eliminating general anesthesia risks in critically ill cardiac patients.
Take-Home Message:
Regional anesthesia enables safe axillary ECMO cannulation in high-risk patients while preserving hemodynamic stability and neurologic monitoring capabilities.
More Related Videos
03:07Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
13:35Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Related Concept Videos
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Local Anesthetics: Clinical Application as Spinal Anesthesia