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

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

Case report, VA-ECMO, Inferior vena cava filter, Extracorporeal cardiopulmonary resuscitation, Pulmonary
embolism

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.
Keywords Case report, VA-ECMO, Inferior vena cava filter, Extracorporeal cardiopulmonary resuscitation, Pulmonary
embolism

Genhua Mu1,2*, Rongliang Xu2

, Yiyun Wang1
, Chun Pan3
and Jianfeng Xie1*

https://doi.org/10.1186/s12245-024-00789-w

2024

Peri Irawan

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