This single-center retrospective study compared planned versus standby V-A ECMO strategies in 74 patients undergoing elective high-risk PCI. Planned ECMO began before PCI; standby support was initiated only after predefined intraprocedural haemodynamic deterioration. In-hospital major adverse cardiac and cerebrovascular events occurred in 48.4% with standby versus 14.0% with planned support (p=0.002). Standby strategy remained associated with higher event odds after adjustment (adjusted OR 4.20; 95% CI 1.35–13.10) and longer ICU stays (8 versus 6 days). These associations do not establish a causal benefit from planned ECMO.
This cohort suggests an association between planned ECMO and fewer in-hospital adverse events during elective high-risk PCI. The findings are hypothesis-generating rather than evidence establishing the superiority of either strategy.
Study limitation: Nonrandomized allocation and few events limit causal inference; the abstract also reports inconsistent standby-group denominators.
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