This study investigates the clinical outcomes of two cannulation strategies—femoral artery (FA) cannulation and combined femoral and axillary artery (FA+AA) cannulation—in patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac surgery. The FA+AA group showed significant benefits in reducing chronic renal failure, platelet drop, and creatinine levels. Despite similar 30-day mortality rates, the combined approach led to fewer complications and faster recovery.