Stroke type and location
Stroke subtype and location based on cannulation site are summarized in Table 2. IS was the most common stroke subtype (64%), followed by HT (20%) and ICH (16%). Among these, location by CT scan was right hemispheric in 38%, left hemispheric in 24%, bilateral in 21%, and vertebrobasilar in 17%.
Stroke incidence did not appear to differ across cannulation strategies: aorta (n=4, 6.5%), axillary artery (n=2, 6.5%), and femoral artery (n=19, 6.2%), (p=0.99). Median days to stroke event from ECMO cannulation were 7.0, 1.74, and 6.0 days for ascending aorta, axillary artery, and femoral artery cannulation, respectively. Stroke patients with axillary cannulation had right hemispheric stroke (n=1, 50%) and vertebrobasilar stroke (n=1, 50%). Those with central cannulation had left hemispheric (n=2, 50%), right hemispheric (n=1, 25%), and bilateral lesions (n=1, 25%). Those with femoral cannulation had right hemispheric (n=9, 39%), left hemispheric (n=5, 22%), bilateral (n=5, 22%), and vertebrobasilar lesions (n=4, 17%) lesions.
Among etiologies for cardiogenic shock, the incidences of stroke seen in patients with acute decompensated heart failure, other etiologies for cardiogenic shock, acute myocardial injury, postcardiotomy shock, and graft dysfunction were 9%, 8%, 7%, 7%, and 4% respectively (p=0.13).