Application of retrograde distal perfusion via posterior tibial artery in venoarterial extracorporeal membrane oxygenation: A retrospective single-center study

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: < .05). No significant difference was observed in survival rates among the groups. Conclusions: In VA-ECMO, retrograde distal perfusion via the PTA is a feasible strategy. Like antegrade distal perfusion, it effectively mitigates lower extremity ischemia.