ECMO support was more frequent in the no-reperfusion group (100%) compared with the surgical embolectomy or catheter-based treatment (64.9%) and systemic thrombolysis groups (40.4%; p < 0.001). Duration of ECMO support was significantly higher in the no-reperfusion group (p = 0.032). Details on reperfusion strategies adopted during hospital stay are reported in Table 1. Of note, surgical embolectomy and catheter-based treatment were performed as a secondary strategy (after systemic thrombolysis) in 15.1% and 11.3% of patients, respectively; systemic thrombolysis was performed as a secondary strategy (after surgical embolectomy or catheter-based treatment) in 1.7% of patients. In-hospital all-cause mortality, successful weaning from ECMO, and fatal bleeding were not significantly different among the three groups. A significantly higher rate of in-hospital major bleeding was observed in the systemic thrombolysis group (44.4%) compared with the surgical embolectomy or catheter-based treatment (22.9%) and no-reperfusion groups (14.8%; p = 0.013). After adjustment for age, cardiac arrest as ECMO indication, and use of immediate (upfront) ECMO, the first reperfusion strategy was not independently associated with in-hospital all-cause mortality (adjusted odds ratio 0.87, 95% confidence interval 0.29-2.60, p = 0.797 for systemic thrombolysis vs. surgical embolectomy or catheter-based treatment; adjusted odds ratio 0.87, 95% confidence interval 0.25-3.07, p = 0.
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