Open AccessVA-ECMO and thrombus aspiration in a pulmonary embolism patient with cardiac arrest and contraindications to thrombolytic therapy
Author(s) -
Alexander C. Reisinger,
Simon FandlerHöfler,
Philipp Kreuzer,
Gábor Tóth-Gayor,
Albrecht Schmidt,
Gary Tse,
Peter Rief,
Philipp Eller,
Marianne Brodmann
Publication year - 2022
Publication title -
vasa
Language(s) - English
Resource type - Journals
eISSN - 1664-2872
pISSN - 0301-1526
DOI - 10.1024/0301-1526/a001019
Subject(s) - medicine , extracorporeal membrane oxygenation , pulmonary embolism , thrombolysis , thrombus , deep vein , thrombosis , anesthesia , surgery , cardiology , myocardial infarction
A 57-year-old male patient with a history of proximal deep vein thrombosis on vitamin K antagonist therapy, suffered a recent hypertensive intracranial hemorrhage without significant neurological deficit. Three weeks later he presented with bilateral central pulmonary embolism. He had witnessed cardiac arrest and was put on veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Endovascular thrombectomy with an Aspirex device led to a significant improvement of hemodynamics. VA-ECMO was terminated after one day, an IVC filter was inserted, and he was discharged from ICU after 15 days. In conclusion, VA-ECMO and endovascular therapy are rescue strategies in patients with contraindications for thrombolysis.