Challenges of acute phase neuroimaging in VA-ECMO, pitfalls and alternative imaging options.

Hassan Aboul NourNeo PoyiadjiGhada MohamedOwais K AlsroujiAhmad-Riad RamadanBrent GriffithHoria MarinAlex Bou Chebl

Published in: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences (2020)

Large vessel occlusion in patients on ECMO is challenging to appreciate clinically secondary to sedation or induced paralysis, thus placing more emphasis on neurovascular imaging. However, emergent CTA and CTP are both inaccurate and unreliable in ECMO patients due to altered circuitry and interference with normal physiologic hemodynamics. In this review, the utility of DSA is discussed in evaluating the altered hemodynamics of VA-ECMO circuits and patency of major vasculature. In addition, the potential use of TCD in ECMO patients is discussed.

Keyphrases

end stage renal disease
extracorporeal membrane oxygenation
acute respiratory distress syndrome
newly diagnosed
ejection fraction
chronic kidney disease
prognostic factors
risk assessment
intensive care unit
respiratory failure
mechanical ventilation
mass spectrometry
drug induced
diabetic rats