This study from the Chinese Extracorporeal Life Support (CSECLS) registry explored the effectiveness of using an intra-aortic balloon pump (IABP) alongside venoarterial extracorporeal membrane oxygenation (VA-ECMO) in patients undergoing treatment for refractory cardiogenic shock or cardiac arrest. Covering data from over 112 member centers, the study analyzed outcomes of 4,755 patients, comparing those who received VA-ECMO with IABP to those who did not. Findings indicated no significant difference in in-hospital mortality rates between the two groups, though IABP use was associated with higher incidences of continuous renal replacement therapy (CRRT) and limb ischemia. These results suggest that while IABP use does not reduce mortality in VA-ECMO patients, it may lead to increased complications, calling for further research and careful clinical decision-making.