Publication Name	World Journal of Critical Care Medicine
Manuscript ID	120664
Country	United Arab Emirates

Category	Critical Care Medicine
Manuscript Type	Minireviews
Article Title	Mitigating limb ischemia in veno-arterial extracorporeal membrane oxygenation: A narrative review of evolving role of distal perfusion catheters
Manuscript Source	Invited Manuscript
All Author List	Nupur Karan, Rohit Patnaik, Santi Swaroop Pattanaik, Arun Vijayakumar, Sugadev Ravinbothayan, Srikant Behera, Chinmaya Panda, Montasir Barakat, Alpa Meshram, Samir Samal and Atul Chawla
Funding Agency and Grant Number
Corresponding Author	Rohit Patnaik, DM, Department of Critical Care Medicine, Medeor 24x7 Hospital, Al Falah Street – Al Danah – Zone 1, Abu Dhabi 40330, United Arab Emirates. rohitpatnaik09@gmail.com
Key Words	Acute limb ischemia; Veno arterial extracorporeal membrane oxygenation; Distal perfusion catheter; Limb perfusion strategies; Near-infrared spectroscopy; Perfusion monitoring; Femoral cannulation; Vascular access techniques
Core Tip	Acute limb ischemia (ALI) is a major complication of femoral veno arterial extracorporeal membrane oxygenation (VA ECMO), driven primarily by impaired distal arterial flow and systemic vasoconstriction. Distal perfusion catheters (DPC) are the most commonly used preventive strategy, though optimal device choice, technique, and timing remain uncertain. Early monitoring with near infrared spectroscopy and emerging tools such as bidirectional cannulas and artificial intelligence-based prediction models may further reduce risk. This review synthesizes current evidence on ALI in peripheral VA-ECMO and provides clear pictorial depictions of the pathophysiology, available methods, and contemporary techniques for DPC placement and practical monitoring.
Citation	Karan N, Patnaik R, Pattanaik SS, Vijayakumar A, Ravinbothayan S, Behera S, Panda C, Barakat M, Meshram A, Samal S, Chawla A. Mitigating limb ischemia in veno-arterial extracorporeal membrane oxygenation: A narrative review of evolving role of distal perfusion catheters. World J Crit Care Med 2026; In press

Received	2026-03-05 02:09
Peer-Review Started	2026-03-05 02:10
First Decision by Editorial Office Director	2026-03-27 10:29
Return for Revision	2026-03-27 10:29
Revised	2026-04-02 07:48
Publication Fee Transferred
Second Decision by Editor	2026-04-24 02:40
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-24 08:21
Articles in Press	2026-04-24 08:21
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2220-3141(online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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