Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation

Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to treat massive pulmonary embolism (PE) accompanied by cardiac arrest or refractory cardiogenic shock. Our team opted for a femoral-femoral approach for vascular cannulation, using drainage and return cannulas in...

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Main Authors: Genhua Mu, Rongliang Xu, Yiyun Wang, Chun Pan, Jianfeng Xie
Format: Article
Language:English
Published: BMC 2024-12-01
Series:International Journal of Emergency Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12245-024-00789-w
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author Genhua Mu
Rongliang Xu
Yiyun Wang
Chun Pan
Jianfeng Xie
author_facet Genhua Mu
Rongliang Xu
Yiyun Wang
Chun Pan
Jianfeng Xie
author_sort Genhua Mu
collection DOAJ
description Abstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to treat massive pulmonary embolism (PE) accompanied by cardiac arrest or refractory cardiogenic shock. Our team opted for a femoral-femoral approach for vascular cannulation, using drainage and return cannulas in the common femoral vein and artery, respectively. However, femoral venous cannulation can be limited or challenging due to the presence of thrombus in the inferior vena cava (IVC), making the insertion of the drainage cannula via the femoral vein difficult. We present the case of a patient with massive PE who underwent aspiration thrombectomy and insertion of an IVC filter, followed by the initiation of VA-ECMO for cardiac arrest. We successfully inserted a femoral venous return ECMO cannula through the inferior vena cava filter during extracorporeal cardiopulmonary resuscitation. The patient stabilized with these interventions and ultimately achieved a favorable outcome with normal neurological status.
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series International Journal of Emergency Medicine
spelling doaj-art-496d1b032f9b4eb3af3bc8861592f3f42025-08-20T01:59:42ZengBMCInternational Journal of Emergency Medicine1865-13802024-12-011711510.1186/s12245-024-00789-wInserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitationGenhua Mu0Rongliang Xu1Yiyun Wang2Chun Pan3Jianfeng Xie4Department of Critical Care Medicine, Zhongda Hospital, Southeast UniversityDepartment of Critical Care Medicine, Yancheng No.1 People’s HospitalDepartment of Critical Care Medicine, Zhongda Hospital, Southeast UniversityDepartment of Critical Care Medicine, Sichuan Academy of Medical Sciences, Sichuan People’s HospitalDepartment of Critical Care Medicine, Zhongda Hospital, Southeast UniversityAbstract Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to treat massive pulmonary embolism (PE) accompanied by cardiac arrest or refractory cardiogenic shock. Our team opted for a femoral-femoral approach for vascular cannulation, using drainage and return cannulas in the common femoral vein and artery, respectively. However, femoral venous cannulation can be limited or challenging due to the presence of thrombus in the inferior vena cava (IVC), making the insertion of the drainage cannula via the femoral vein difficult. We present the case of a patient with massive PE who underwent aspiration thrombectomy and insertion of an IVC filter, followed by the initiation of VA-ECMO for cardiac arrest. We successfully inserted a femoral venous return ECMO cannula through the inferior vena cava filter during extracorporeal cardiopulmonary resuscitation. The patient stabilized with these interventions and ultimately achieved a favorable outcome with normal neurological status.https://doi.org/10.1186/s12245-024-00789-wCase reportVA-ECMOInferior vena cava filterExtracorporeal cardiopulmonary resuscitationPulmonary embolism
spellingShingle Genhua Mu
Rongliang Xu
Yiyun Wang
Chun Pan
Jianfeng Xie
Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
International Journal of Emergency Medicine
Case report
VA-ECMO
Inferior vena cava filter
Extracorporeal cardiopulmonary resuscitation
Pulmonary embolism
title Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
title_full Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
title_fullStr Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
title_full_unstemmed Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
title_short Inserting a VA-ECMO cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
title_sort inserting a va ecmo cannula through an inferior vena cava filter during extracorporeal cardiopulmonary resuscitation
topic Case report
VA-ECMO
Inferior vena cava filter
Extracorporeal cardiopulmonary resuscitation
Pulmonary embolism
url https://doi.org/10.1186/s12245-024-00789-w
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