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Chokri Ben Lamine: VA-ECMO vs VV-ECMO Thromboembolic Events – Key Clinical Pearls
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Apr 15, 2026, 16:55

Chokri Ben Lamine: VA-ECMO vs VV-ECMO Thromboembolic Events – Key Clinical Pearls

Chokri Ben Lamine, Adult Hematology and SCT Assistant Consultant at Oncology Center of Excellence at King Faisal Specialist Hospital and Research Center, shared a post on X:

“VA-ECMO vs VV-ECMO Thromboembolic Events – Key Clinical Pearls

Credits: Dr Hazzaa Alzahrani – KFSHRC

VA-ECMO equals Cardiac plus Respiratory support – higher overall thrombotic risk

VV-ECMO equals Respiratory only – high risk but mainly venous/circuit-related

Risk profile

  • VA-ECMO – high arterial plus venous thrombosis (shock, low flow, arterial cannulation)
  • VV-ECMO – predominantly venous plus circuit thrombosis (less arterial)

Thrombotic pattern

  • VA – arterial embolism, stroke, limb ischemia, intracardiac thrombus
  • VV – oxygenator clot, circuit thrombosis, cannula-related DVT, VTE

Incidence

  • VA – ~17% thrombotic complications (meta-analysis)
  • VV – up to ~40% reported (mostly circuit-related)

Limb ischemia

  • VA – COMMON (10–30%) due to arterial cannulation major complication
  • VV – RARE (no arterial access)

Stroke / systemic embolism

  • VA – HIGH risk – thrombus forms in heart/aorta – embolizes systemically
  • VV – LOWER – mainly venous events, less arterial embolism

Intracardiac thrombosis

  • VA – typical (LV stasis, poor ejection, inadequate unloading)
  • VV – NOT typical

Cannula-associated DVT (post-decannulation)

  • VV – COMMON, often underdiagnosed
  • VA – occurs but less emphasized

Why different?

  • VA – shock, low pulsatility, arterial cannulation, LV stasis, endothelial injury
  • VV – large venous cannulas, long runs, inflammation, hemolysis, circuit shear stress

Clinical takeaway

  • VA-ECMO equals arterial plus embolic complications dominate – stroke and limb ischemia vigilance
  • VV-ECMO equals venous/circuit thrombosis dominate – DVT and oxygenator monitoring”

More posts featuring Chokri Ben Lamine on Hemostasis Today.

Chokri Ben Lamine DVT Health Hematology Hemostasis Hemostasis News Hemostasis Today Medicine thrombosis VA-ECMO VA-ECMO Thromboembolic Events VTE VV-ECMO VV-ECMO Thromboembolic Events
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