Extracorporeal Cardiopulmonary Resuscitation for 78‐min Cardiac Arrest due to Suspected Cerebral Venous Sinus Thrombosis

A 37-year-old man had a cardiac arrest. His colleagues started CPR and called an ambulance to our emergency department. The ECMO team assessed him and initiated ECPR. Coronary, left ventricular, and pulmonary angiography showed no abnormalities. The patient had pupil dilation, prompting a bilateral decompressive craniectomy under heparin-free ECMO support. Postoperatively, pupils remained dilated until cerebral angiography revealed venous sinus thrombosis, prompting anticoagulation therapy, which led to pupil constriction and partial neurological recovery. The patient was weaned off ECMO and was transferred to a rehabilitation hospital. Successful resuscitation after prolonged cardiac arrest using ECPR, bilateral decompressive craniectomy, and CVST treatment is rare.