During peripheral extracorporeal veno-arterial membrane oxygenation (VA-ECMO) support, subclavian arterial cannulation provides, in comparison to femoral arterial cannulation, an anterograde flow which may prevent from left ventricular (LV) distention and improve outcomes.

We aimed to compare the effectiveness of subclavian cannulation to femoral cannulation in reducing LV overdistension consequences, hemostatic complications and mortality.

Subclavian artery cannulation was not associated with reduced LV distension related complications, thrombotic complications and 28-day mortality.

Rather, it may increase serious bleeding and accidental decannulations, and reduce recovery.

Therefore, subclavian cannulation should be limited to vascular accessibility issues.

As compared to femoral cannulation (n=320 patients), subclavian cannulation (n=52 patients) did not reduce the occurrence of new onset of PO or LV unloading after PSM.

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