Challenges of acute phase neuroimaging in VA-ECMO, pitfalls and alternative imaging options. Issue 3 (June 2021)

• Record Type: Journal Article
• Authors: Aboul Nour, Hassan; Poyiadji, Neo; Mohamed, Ghada; Alsrouji, Owais K; Ramadan, Ahmad-Riad; Griffith, Brent; Marin, Horia; Chebl, Alex Bou
• Is Part Of: Interventional neuroradiology. Volume 27:Issue 3(2021)
• Page Start: 434
• Page End: 439
• Publication Date: 2021-06
• Subjects: Stroke -- angiography -- ECMO -- neuroimaging; Nervous system -- Interventional radiology -- Periodicals; Nervous system -- Radiography -- Periodicals; Nervous System Diseases -- Periodicals -- radiography; Neuroradiography -- Periodicals; Radiography, Interventional -- Periodicals; Nervous system -- Radiography; Periodicals; 617.4805
• DOI: 10.1177/1591019920962881
• Languages: English
• ISSNs: 1591-0199

Abstract

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.