{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:11:04Z","timestamp":1760145064024,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objective: Although extracorporeal membrane oxygenation (ECMO) is an essential life-saving technique for patients with refractory cardiopulmonary shock, it can be fatal in certain cases. Case Presentation: A 19-year-old girl treated with ECMO presented with acute limb ischemia 2 days after cannula removal. The decannulation was performed percutaneously by an interventional cardiologist, and the vascular surgery department was consulted after the patient developed symptoms. The first suspected diagnosis was thrombosis due to incorrect use of the closure device. However, the artery had ruptured due to the insertion of a catheter with a cannula that was larger than the patient\u2019s artery. Management and Outcome: Fortunately, excessive bleeding due to the size-mismatched cannula was prevented by an unintentional complication of the closing device, which saved the patient\u2019s life. She underwent a right common femoral artery thrombectomy and patch angioplasty. Hospital guidelines have changed regarding the surgical removal of ECMO cannulas. Discussion: This report aims to highlight the importance of two aspects that are critical to a successful outcome: individualized cannula selection followed by precise insertion and removal and postoperative evaluation of a patient\u2019s final status.<\/jats:p>","DOI":"10.3390\/medicina60060969","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T06:47:30Z","timestamp":1718174850000},"page":"969","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Critical Hemorrhage Caused by a Size-Mismatched Extracorporeal Membrane Oxygenation Cannula in a Patient with Myotonic Dystrophy Type 1: A Case Report and Literature Review"],"prefix":"10.3390","volume":"60","author":[{"given":"Changsik","family":"Shin","sequence":"first","affiliation":[{"name":"Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu 11759, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4763-7530","authenticated-orcid":false,"given":"Kwon Cheol","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea"},{"name":"Department of Surgery, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9873-4907","authenticated-orcid":false,"given":"Dae Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, Chungbuk National University, Cheongju 28644, Republic of Korea"},{"name":"Department of Surgery, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/s00134-018-5064-5","article-title":"Position paper for the organization of ECMO programs for cardiac failure in adults","volume":"44","author":"Abrams","year":"2018","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.athoracsur.2016.10.023","article-title":"Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock in elderly patients: Trends in application and outcome from the extracorporeal life support organization (ELSO) registry","volume":"104","author":"Lorusso","year":"2017","journal-title":"Ann. 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