Molding thrombus of an ECMO cannula in the inferior vena cava

A 21-year-old male patient who was admitted in the ICU after multiple traumas suffered hemodynamic and respiratory deterioration requiring peripheral veno-venous extracorporeal membrane oxygenation (VV ECMO) support as a bridge to recovery within the first forty-eight hours of his hospital admission. Thanks to this therapy, he significantly improved allowing the withdrawal of ECMO 144 hours after its implantation. However, the bedside ultrasound exam performed after the ECMO removal reported a hyperechogenic mass inside in the inferior vena cava (IVC). Due to its sonographic characteristics, a molding thrombus of the femoral ECMO cannula was suspected. Subcutaneous enoxaparin was given for 1 mg/ kg every 12 hours until the thrombus disappeared.