FATAL VASCULAR COMPLICATION AT PERIPHERIC VA ECMO. IT IS POSSIBLE TO AVOID OR NOT?

This article describes the possible and fatal vascular complication after cannulation for peripheral ECPR (venoarterial ECMO). A patient with cardiac arrest was deemed to be placed to ECMO via cannulation of femoral artery and vein. During ongoing chest compressions femoral artery was cannulated and it was complicated by hemorrhagic shock. The consequent autopsy revealed a lengthwise arterials wall tear and abnormal position of artery and vein between each other. We believe that obtaining information about vascular bed (vessels dimension, location artery and vein and its branches) via any available imaging tool, ultrasound navigation, checking the proper position each line inside each vessel could help to avoid such tragic event.