Abstract
We report two cases of extracorporeal membrane oxygenation (ECMO) catheter misplacement in the ascending lumbar vein from the femoral vein. One case was a man in his thirties undergoing venoarterial ECMO because of shock-resistant ventricular fibrillation. The other case was a woman in her fifties undergoing venovenous ECMO for severe hypoxia. In both cases, the venous cannulation site for the drainage catheter was the right femoral vein. Although anteroposterior abdominal radiographs did not indicate the catheter malposition, abdominal CT showed that the drainage catheters were placed in the right ascending lumbar vein instead of the inferior vena cava. It is difficult to distinguish on anteroposterior abdominal radiographs whether the catheter is placed in the inferior vena cava or the ascending lumbar vein, but it is reported that lateral abdominal radiographs are useful for detection of catheter malposition. The use of a J-type guidewire rather than a straight or angle-type guidewire to insert the venous catheter may avoid misplacement in the ascending lumbar vein.
