A proposed clinical guide to delivering Lower Extremity Extracorporeal Distal Revascularization (LEEDR) as a bridge to definitive care in acute limb ischemia

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.