{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T16:22:30Z","timestamp":1792858950246,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T00:00:00Z","timestamp":1718150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>For veno-arterial extracorporeal membrane oxygenation (ECMO), the femoral artery is the preferred cannulation site (femoro-femoral: Vf-Af). This results in retrograde aortic flow, which increases the left ventricular afterload and can lead to severe pulmonary edema and thrombosis of the cardiac chambers. Right axillary artery cannulation (femoral-axillary: Vf-Aa) provides partial anterograde aortic flow, which may prevent some complications. This study aimed to compare the 90-day mortality and complication rates between VF-AA and VF-AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Consecutive adult patients with cardiogenic shock who received peripheral VA-ECMO between 2013 and 2019 at our institution were retrospectively included. The exclusion criteria were refractory cardiac arrest, multiple VA-ECMO implantations due to vascular access changes, weaning failure, or ICU readmission. A statistical approach using inverse probability of treatment weighting was used to estimate the effect of the cannulation site on the outcomes. The primary endpoint was the 90-day mortality. The secondary endpoints were vascular access complications, stroke, and other complications related to retrograde blood flow. Outcomes were estimated using logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      VA-ECMO was performed on 534 patients. Patients with refractory cardiac arrest (\n                      <jats:italic>n<\/jats:italic>\n                      = 77 (14%)) and those supported by multiple VA-ECMO (\n                      <jats:italic>n<\/jats:italic>\n                      = 92, (17%)) were excluded. Out of the 333 patients studied (\n                      <jats:italic>n<\/jats:italic>\n                      = 209 Vf-Aa;\n                      <jats:italic>n<\/jats:italic>\n                      = 124 VF-AF), the main indications for VA-ECMO implantation were post-cardiotomy (33%,\n                      <jats:italic>n<\/jats:italic>\n                      = 109), dilated cardiomyopathy (20%,\n                      <jats:italic>n<\/jats:italic>\n                      = 66), post-cardiac transplantation (15%,\n                      <jats:italic>n<\/jats:italic>\n                      = 50), acute myocardial infarction (14%,\n                      <jats:italic>n<\/jats:italic>\n                      = 46) and other etiologies (18%,\n                      <jats:italic>n<\/jats:italic>\n                      = 62). The median SOFA score was 9 [7-11], and the crude 90-day mortality rate was 53% (\n                      <jats:italic>n<\/jats:italic>\n                      = 175). After IPTW, the 90-day mortality was similar in the Vf-Aa and VF-AF groups (54% vs 58%, IPTW-OR = 0.84 [0.54-1.29]). Axillary artery cannulation was associated with significantly fewer local infections (OR = 0.21, 95% CI:0.09-0.51), limb ischemia (OR = 0.37, 95% CI:0.17-0.84), bowel ischemia (OR = 0.16, 95% CI:0.05-0.51) and pulmonary edema (OR = 0.52, 95% CI:0.29-0.92) episodes, but with a higher rate of stroke (OR = 2.87, 95% CI:1.08-7.62) than femoral artery cannulation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared to VF-AF, axillary cannulation was associated with similar 90-day mortality rates. The high rate of stroke associated with axillary artery cannulation requires further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591241261330","type":"journal-article","created":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:28:37Z","timestamp":1718238517000},"page":"858-868","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Femoro-axillary versus femoro-femoral veno-arterial extracorporeal membrane oxygenation for refractory cardiogenic shock: A monocentric retrospective study"],"prefix":"10.1177","volume":"40","author":[{"given":"Julien Do","family":"Vale","sequence":"first","affiliation":[{"name":"Anesthesiology and Surgical Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9888-3280","authenticated-orcid":false,"given":"Elie","family":"Kantor","sequence":"additional","affiliation":[{"name":"Anesthesiology and Surgical Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9gory","family":"Papin","sequence":"additional","affiliation":[{"name":"Anesthesiology and Surgical Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Sonneville","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine and Infectious Diseases, AP-HP, Bichat Hospital, Paris, France"},{"name":"UMR1148, LVTS, Sorbonne Paris Cit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Braham","sequence":"additional","affiliation":[{"name":"Assistance Publique Des Hopitaux de Paris, Bichat Hospital, Service de Chirurgie Cardiaque, Paris Diderot University, Sorbonne Paris Cit\u00e9, INSERM\/Paris Diderot University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4857-5474","authenticated-orcid":false,"given":"Marylou","family":"Para","sequence":"additional","affiliation":[{"name":"Assistance Publique Des Hopitaux de Paris, Bichat Hospital, Service de Chirurgie Cardiaque, Paris Diderot University, Sorbonne Paris Cit\u00e9, INSERM\/Paris Diderot University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Montravers","sequence":"additional","affiliation":[{"name":"Anesthesiology and Surgical Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France"},{"name":"INSERM Unit U1152, Universit\u00e9 de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Longrois","sequence":"additional","affiliation":[{"name":"Anesthesiology and Surgical Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France"},{"name":"INSERM Unit U1148, Universit\u00e9 de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Provench\u00e8re","sequence":"additional","affiliation":[{"name":"Anesthesiology and Surgical Critical Care Department, DMU PARABOL, AP-HP, Bichat Hospital, Paris, France"},{"name":"INSERM CIC-EC 1425, AP-HP, Bichat Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,6,12]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002128"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2333"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.038"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezaa283"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31047-3"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003879"},{"issue":"4","key":"e_1_3_5_8_2","first-page":"169","article-title":"Flux r\u00e9trograde de la circulation extracorporelle avec oxyg\u00e9nateur \u00e0 membrane. 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