Routine Versus Provisional Distal Perfusion Catheter Placement in Patients Undergoing Mechanical Circulatory Support

Inclusion Criteria: * Patients aged 19 years old * Cardiogenic shock requiring mechanical circulatory support through femoral artery approach * Subject who can verbally confirm understandings of risks and benefits of receiving distal perfusion catheter insertion and he/she or his/her legally authorized representative provides written informed consent prior to any study related procedure. * Under the critically-ill clinical circumstance (unclear consciousness of patient), legally authorized representative can provide written informed consent prior to any study related procedure. Exclusion Criteria: * Apparent symptoms and sign of acute limb ischemia immediately after mechanical circulatory support insertion * Significant coagulopathy precluding invasive procedure due to high risk of bleeding * Pregnant women, women with potential childbearing, or lactating women * Irreversible limb ischemia requiring interventional procedures or surgery at the time of MCS insertion * Previous history if femoral-femoral bypass grafting or femoral-popliteal bypass grafting * Previous history of limb amputation * Unwilling or unable to obtain informed consent from the participant or legally authorized representative