| Summary: | A 53-year-old woman presented with dyspnea. She had undergone extended thymectomy for
an invasive thymoma two months prior. CT revealed numerous small nodules in the lung. After
that, she deteriorated owing to acute respiratory distress syndrome (ARDS), and the vascular
surgeon planned veno-venous extracorporeal membrane oxygenation (ECMO). During percutaneous
cannulation through the left femoral vein, a vascular injury was suspected, and the patient’s
vital signs became unstable. Diagnostic angiography showed a ruptured left common iliac
vein, and the bleeding was stopped by placement of a stent-graft. May-Thurner syndrome
was diagnosed on abdominal CT. Here, we report a rare case of ECMO-related vascular injury in
a patient with an unrecognized anatomical variant, May-Thurner syndrome.
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