Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report

Abstract Background The use of venovenous extracorporeal membrane oxygenation (VV ECMO) for severe adult respiratory failure is rapidly increasing worldwide. To date, no studies have documented early-onset superior vena cava (SVC) stenosis caused solely by ECMO cannula placement in adults without pr...

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Main Authors: Xiao Song, Jian Wang, Liang Zong, Hui Jiang, Di Shi, Huadong Zhu
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Pulmonary Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12890-025-03851-2
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author Xiao Song
Jian Wang
Liang Zong
Hui Jiang
Di Shi
Huadong Zhu
author_facet Xiao Song
Jian Wang
Liang Zong
Hui Jiang
Di Shi
Huadong Zhu
author_sort Xiao Song
collection DOAJ
description Abstract Background The use of venovenous extracorporeal membrane oxygenation (VV ECMO) for severe adult respiratory failure is rapidly increasing worldwide. To date, no studies have documented early-onset superior vena cava (SVC) stenosis caused solely by ECMO cannula placement in adults without pre-existing anatomical abnormalities, leading to SVC syndrome. Case presentation We report the first case of SVC syndrome in an adult patient with pre-existing SVC angulation, exacerbated by cannula placement during VV ECMO therapy. Serial venous-phase chest CT scans (pre-ECMO and during ECMO support) demonstrated progressive luminal narrowing at the cannula tip site, correlating with clinical manifestations of SVC obstruction. The patient was successfully weaned from VV ECMO, achieved complete resolution of SVC syndrome symptoms, and was discharged without neurological sequelae. Conclusions This case provides definitive imaging evidence that ECMO cannula placement alone can induce acute SVC stenosis in patients with pre-existing vascular tortuosity. Our findings strongly advocate for pre-procedural vascular imaging assessment and real-time monitoring during ECMO support to mitigate this life-threatening complication.
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series BMC Pulmonary Medicine
spelling doaj-art-1fcfcd7864874c9ebedc49ed6397a3f62025-08-20T03:42:37ZengBMCBMC Pulmonary Medicine1471-24662025-08-012511610.1186/s12890-025-03851-2Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case reportXiao Song0Jian Wang1Liang Zong2Hui Jiang3Di Shi4Huadong Zhu5Emergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Radiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeEmergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background The use of venovenous extracorporeal membrane oxygenation (VV ECMO) for severe adult respiratory failure is rapidly increasing worldwide. To date, no studies have documented early-onset superior vena cava (SVC) stenosis caused solely by ECMO cannula placement in adults without pre-existing anatomical abnormalities, leading to SVC syndrome. Case presentation We report the first case of SVC syndrome in an adult patient with pre-existing SVC angulation, exacerbated by cannula placement during VV ECMO therapy. Serial venous-phase chest CT scans (pre-ECMO and during ECMO support) demonstrated progressive luminal narrowing at the cannula tip site, correlating with clinical manifestations of SVC obstruction. The patient was successfully weaned from VV ECMO, achieved complete resolution of SVC syndrome symptoms, and was discharged without neurological sequelae. Conclusions This case provides definitive imaging evidence that ECMO cannula placement alone can induce acute SVC stenosis in patients with pre-existing vascular tortuosity. Our findings strongly advocate for pre-procedural vascular imaging assessment and real-time monitoring during ECMO support to mitigate this life-threatening complication.https://doi.org/10.1186/s12890-025-03851-2ECMOSuperior Vena Cava syndromeSuperior Vena Cava stenosisVascular angulationVascular complication
spellingShingle Xiao Song
Jian Wang
Liang Zong
Hui Jiang
Di Shi
Huadong Zhu
Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report
BMC Pulmonary Medicine
ECMO
Superior Vena Cava syndrome
Superior Vena Cava stenosis
Vascular angulation
Vascular complication
title Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report
title_full Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report
title_fullStr Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report
title_full_unstemmed Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report
title_short Venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre-existing stenosis in an adult patient: a case report
title_sort venovenous extracorporeal membrane oxygenation catheter related superior vena cava syndrome without pre existing stenosis in an adult patient a case report
topic ECMO
Superior Vena Cava syndrome
Superior Vena Cava stenosis
Vascular angulation
Vascular complication
url https://doi.org/10.1186/s12890-025-03851-2
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