What question did this study set out to answer?

This analysis aims to characterize one-year outcomes and long-term sequelae after V-A ECMO in high-risk pulmonary embolism patients.

May 20, 2026

B67-06 One-Year Outcomes Following Veno-ArterialExtracorporeal Membrane Oxygenationin High-Risk Pulmonary Embolism: A Multicenter Real-World Analysis

Key Points

This analysis aims to characterize one-year outcomes and long-term sequelae after V-A ECMO in high-risk pulmonary embolism patients.
Analyzed data from 1,605 adults with high-risk PE who underwent V-A ECMO from 2005 to 2024.
Evaluated outcomes including mortality, major adverse cardiovascular events, and readmissions using Kaplan-Meier survival analysis.
Gathered data from the TriNetX U.S. Collaborative Network.
One-year survival rate was 90.9%.
Major adverse cardiovascular events (MACE) occurred in 9.0%, chronic kidney disease (CKD) in 11.0%, and cerebrovascular accidents (CVA) in 5.7%.
14.2% of patients experienced hospital readmission within one year.

Abstract

Abstract Background Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is increasingly utilized as a rescue modality for patients with high-risk pulmonary embolism (PE) complicated by cardiogenic shock or circulatory collapse. However, long-term outcomes beyond hospital discharge remain poorly characterized, limiting understanding of survivorship and late sequelae in this population. Methods Using the TriNetX U.S. Collaborative Network encompassing 70 healthcare organizations, we identified adults (≥ 18 years) with high-risk PE defined by acute PE with hemodynamic compromise (shock, cardiac arrest, or severe hypotension) who underwent V-A ECMO between 2005 and 2024. Outcomes between 90 days and one year post-index were analyzed, including all-cause mortality, major adverse cardiovascular events (MACE), chronic kidney disease (CKD), cerebrovascular accident (CVA), chronic thromboembolic pulmonary hypertension (CTEPH), deep-vein thrombosis (DVT), and hospital readmission. We acknowledge that long-term event capture in real-world databases such as TriNetX may underestimate outcomes occurring outside participating systems. Kaplan-Meier survival and risk analyses were performed. Results Among 1,605 patients (mean age 54.2 ± 16.2 years; 55% male; 62% White; 24% Black), one-year survival was 90.9%. Within one year post-ECMO, MACE occurred in 9.0%, CKD in 11.0%, CVA in 5.7%, CTEPH in 2.1%, DVT in 6.2%, and readmission in 14.2%. Most late events clustered within six months after discharge, reflecting persistent multi-organ vulnerability despite early survival gains. Conclusions In this large, multi-center real-world cohort of patients receiving V-A ECMO for high-risk PE, long-term survival exceeded 90%, yet substantial morbidity persisted, particularly renal dysfunction and cardiovascular complications. Compared with prior single-center reports, our findings suggest favorable survival but highlight the ongoing burden of post-ECMO sequelae, underscoring the need for structured longitudinal follow-up and multidisciplinary post-ECMO care pathways. This abstract is funded by: None

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