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Individuals requiring transplantation represent the sickest cohort of patients with end-stage lung failure. Commonly, they have multiple comorbidities that carry significant risk for post-transplant recovery. Clinical circumstances, such as widespread clots and vascular thrombosis, require novel approaches in attempt to provide extracorporeal life support. We present a patient, who developed respiratory failure during recovery from bilateral lung transplantation, complicated by internal jugular vein thrombosis and an inferior vena cava filter in situ. She was cannulated with a ProtekDuo via the right external jugular vein due to lack of other patent vessels, representing a first in man method description.