ArticleJTCVS techniques2026
Application of retrograde distal perfusion via posterior tibial artery in venoarterial extracorporeal membrane oxygenation: A retrospective single-center study.
Article in JTCVS techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to evaluate the feasibility of retrograde distal perfusion via the posterior tibial artery (PTA) in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods: A retrospective single-center study was performed on the clinical data of 48 patients who underwent VA-ECMO and were administered retrograde distal perfusion between April 2023 and July 2025. The surgical technique for cannulation via the PTA was described, and this perfusion approach was compared with antegrade distal perfusion. Results: All 48 cases of retrograde distal perfusion were successfully achieved via surgical cannulation. The cannula size was mainly 6 Fr, and the cannulation time was 18.98 ± 4.10 minutes. Imaging studies confirmed that retrograde blood flow could ascend to the superficial femoral artery and deep femoral artery. Compared with the antegrade approach (comprising 93 percutaneous and 23 surgical cases), the retrograde method achieved a significantly greater cannulation success rate than the percutaneous approach (95.83% [46/48] vs 53.76% [50/93], Conclusions: In VA-ECMO, retrograde distal perfusion via the PTA is a feasible strategy. Like antegrade distal perfusion, it effectively mitigates lower extremity ischemia.
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