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CTPA revealed massive bilateral pulmonary embolism. The patient underwent catheter\u2010directed mechanical thrombectomy (CDMT) under general anesthesia, complicated by cardiogenic shock necessitating cardiopulmonary resuscitation (CPR). Post ROSC, venoarterial ECMO was initiated, and catheter\u2010directed thrombolysis was performed. CDMT was reattempted but not fully successful, and the patient developed right heart failure with pulmonary hypertension. ECMO continued for 5 days and gradually weaned off. He was extubated successfully on Day 7 and discharged home later.<\/jats:p>","DOI":"10.1155\/crcc\/5573593","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T03:33:39Z","timestamp":1750649619000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Clots: The Role of Cardiac Anesthesiologists in a Case of ECMO for Massive Pulmonary Embolism"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3989-3286","authenticated-orcid":false,"given":"Vimal","family":"Varma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isqandar","family":"Adnan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Engku","family":"Naim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rusnaini","family":"Mustapha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"e_1_2_10_1_2","unstructured":"MASCAP Guidelines for Adult Extracorporeal Membrane Oxygenation (ECMO) (1st Ed.) 2023 https:\/\/mascap.org.my\/wp-content\/uploads\/2023\/09\/GUIDELINES-FOR-ADULT-EXTRACORPOREAL-MEMBRANE-OXYGENATION-with-cover-.pdf."},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.5772\/63309"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12186067"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001887"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-05059-y"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003407"},{"key":"e_1_2_10_7_2","unstructured":"Critical Care Anesthesiology 2022 Yale Medicine https:\/\/www.yalemedicine.org\/conditions\/critical-care-anesthesiology."},{"key":"e_1_2_10_8_2","article-title":"The Post-ICU Patient","volume":"20","author":"Vincent J. 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