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Case Reports
. 2024 Jul 5:51:102083.
doi: 10.1016/j.rmcr.2024.102083. eCollection 2024.

Overcoming challenges in the treatment of massive pulmonary embolism in the elderly: Role of extracorporeal membrane oxygenation

Shasha Wu  1 , Jun Liu  2 , Shifeng Shao  1
Affiliations
Case Reports

Overcoming challenges in the treatment of massive pulmonary embolism in the elderly: Role of extracorporeal membrane oxygenation

Shasha Wu et al. Respir Med Case Rep. .

Abstract

Population aging represents a paramount medical and socio-demographic challenge globally. As living standards improve and medical technology advances, the elderly population experiences an increasing number of detected and treated pulmonary embolisms (PE). However, rescuing massive pulmonary embolism (MPE) in the elderly remains a difficult task. Conventional thrombolysis or surgical thrombolysis might be contraindicated, leading extracorporeal membrane oxygenation (ECMO) to emerge as a treatment modality for MPE in the elderly. Nevertheless, data are scarce regarding the use of ECMO as a standalone treatment for MPE. In this paper, we present the case of an 85-year-old patient with a prior cerebral infarction, who received a diagnosis of MPE in the main trunks of bilateral pulmonary arteries. Considering the patient's systemic condition, the Pulmonary Embolism Response Team (PERT) opted to administer VA-ECMO as the sole treatment approach. Remarkably, the patient achieved a favorable recovery outcome. Our case report contributes new evidence to the treatment of elderly individuals with MPE and highlights the potential of ECMO-only regimens for addressing such cases.

Keywords: ECMO; Elderly; Pulmonary embolism; Treatment outcomes.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
On the day of admission, enhanced CT showed bilateral pulmonary artery trunk embolization.
Fig. 2
Fig. 2
On the 4th day of hospitalization, bilateral pulmonary angiography showed good vascular filling.
See this image and copyright information in PMC

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