Ding LS, Liang H, Zheng M, Shen M, Li ZJ, Song RP, Chen QL. Extracorporeal membrane oxygenation states basilar artery thrombectomy and left posterior cerebral artery stent thrombectomy: A case report. World J Clin Cases 2024; 12(18): 3589-3595 [PMID: 38983431 DOI: 10.12998/wjcc.v12.i18.3589]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Li-Shan Ding, Department of Radioactive Intervention, Henan University of Traditional Chinese Medicine, Zhengzhou 450099, Henan Province, China
Hao Liang, Ming Zheng, Meng Shen, Zhao-Jun Li, Qing-Liang Chen, Department of Radioactive Intervention, Henan No. 3 Provincial People’s Hospital, Zhengzhou 450006, Henan Province, China
Rui-Peng Song, Department of Endocrinology, Henan No. 3 Provincial People’s Hospital, Zhengzhou 450000, Henan Province, China
Author contributions: All authors listed have made a substantial, direct, and intellectual contribution to the work; Ding LS, Chen QL designed the study, collected the data, and drafted the manuscript; Liang H, Zheng M, LI ZJ, and Shen M analyzed the data; Song RP supervised this study; All authors read and approved the final manuscript.
Supported byJoint Projects of the Medical Science and Technology Research Program of Henan Province, No. LHGJ20210255.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: February 29, 2024 Revised: April 14, 2024 Accepted: April 22, 2024 Published online: June 26, 2024 Processing time: 110 Days and 6.6 Hours
Abstract
BACKGROUND
Extracorporeal membrane oxygenation (ECMO) is a new type of extracorporeal respiratory and circulatory assistance device. It can drain venous blood out of the body and inject it into veins or arteries after being oxygenated by an oxygenator (membrane lung) to replace lung and heart functions in a short time. ECMO can provide tissue blood perfusion and gas exchange almost equivalent to cardiac output and extend the effective treatment time window for patients with acute circulatory failure to restore cardiopulmonary function.
CASE SUMMARY
We report a case of an 81-year-old woman who underwent whole cerebral angiography, basilar artery thrombectomy and stent thrombectomy in the posterior artery of the left brain after implantation of ECMO. The patient was admitted to the hospital due to myocardial infarction. Considering that the cause of the patient’s disturbance of consciousness was unknown and cerebrovascular accident could not be ruled out after the implantation of ECMO, the department of Radioactive Intervention performed cerebral angiography. And the result of the angiography indicated vascular occlusion. After the basilar artery thrombectomy and stent thrombectomy in the posterior artery of the left brain, the patency of the occlusive vessel was achieved.
CONCLUSION
Although the patient eventually died of circulatory failure, the result of this case verifies the feasibility of cerebral angiography and thrombectomy in patients with implanted ECMO in the intubated state.
Core Tip: Extracorporeal membrane oxygenation (ECMO)-supported total cerebral angiography, catheter thrombectomy and stent thrombectomy are very rare, and no similar cases have been reported on PubMed. We report a case of an 81-year-old woman who underwent whole cerebral angiography, basilar artery thrombectomy and stent thrombectomy in the posterior artery of the left brain after implantation of ECMO. This article describes in detail the preoperative evaluation of the patient's condition, the difficult operation and anticoagulation regimen during the operation, as well as the postoperative management. The results of this case verify the feasibility of cerebral angiography and thrombectomy in patients with ECMO implantation under intubation.
