156 T. Takeichi et al.: J Extra Corpor Technol 2025, 57, 153--159 Figure 3.( a, b) The transition of TOI, DO 2 Hb, and DHHb between the cerebral and lower limb. TOI: Tissue oxygenation index; DO 2 Hb: Oxyhemoglobin change rate; DHHb: Deoxyhemoglobin change rate.
Discussion
TAAD outcomes are significantly influenced by the extent and location of the dissection, with reported mortality rates ranging from 15 % to 30 % [ 1 ]. When TAAD is complicated by malperfusion, the mortality rate increases to as high as 43 %, with lower-extremity malperfusion occurring in approximately 20--30 % of cases, and the preoperative presence of limb ischemia has been shown to double the risk of mortality and adversely impact long-term survival [ 2--6 ].
The selection of an appropriate cannulation strategy in TAAD necessitates meticulous planning, as certain techniques may exacerbate complications. Femoral artery cannulation, while advantageous due to its accessibility and familiarity to surgeons, poses risks such as malperfusion, retrograde perfusion-induced aortic branch vessel ischemia, propagation of