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).