Axillary versus femoral cannulation for aortic surgery: enough evidence for a general recommendation?
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Axillary versus femoral cannulation for aortic surgery: enough evidence for a general recommendation? / Gulbins, Helmut; Pritisanac, Anita; Ennker, Jürgen.
In: ANN THORAC SURG, Vol. 83, No. 3, 03.2007, p. 1219-1224.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Axillary versus femoral cannulation for aortic surgery: enough evidence for a general recommendation?
AU - Gulbins, Helmut
AU - Pritisanac, Anita
AU - Ennker, Jürgen
PY - 2007/3
Y1 - 2007/3
N2 - There is a trend towards cannulation of the axillary artery for extracorporeal circulation in patients requiring aortic arch surgery. We analyzed the published data comparing axillary and femoral cannulation for safety and outcome. End points were death; stroke, neurologic, and vascular complications; and malperfusion. Femoral cannulation is safe for extracorporeal circulation in patients without aortic arch surgery. In patients with type A dissections, malperfusion may occur owing to retrograde perfusion of the false lumen and subsequent occlusion of the origin of the supra aortic vessels. Cannulation of the axillary/subclavian artery results in antegrade flow, at least in the right carotid artery, with the possibility of antegrade cerebral perfusion during aortic arch repair. There was a trend towards improved neurologic outcome when the axillary artery was used for extracorporeal circulation in such patients. When different techniques were compared, the use of a side graft for axillary cannulation reduced the complication rate. The lack of randomized trials and the high variety of inclusion criteria in the different studies do not allow a general recommendation for the use of the axillary artery as cannulation site.
AB - There is a trend towards cannulation of the axillary artery for extracorporeal circulation in patients requiring aortic arch surgery. We analyzed the published data comparing axillary and femoral cannulation for safety and outcome. End points were death; stroke, neurologic, and vascular complications; and malperfusion. Femoral cannulation is safe for extracorporeal circulation in patients without aortic arch surgery. In patients with type A dissections, malperfusion may occur owing to retrograde perfusion of the false lumen and subsequent occlusion of the origin of the supra aortic vessels. Cannulation of the axillary/subclavian artery results in antegrade flow, at least in the right carotid artery, with the possibility of antegrade cerebral perfusion during aortic arch repair. There was a trend towards improved neurologic outcome when the axillary artery was used for extracorporeal circulation in such patients. When different techniques were compared, the use of a side graft for axillary cannulation reduced the complication rate. The lack of randomized trials and the high variety of inclusion criteria in the different studies do not allow a general recommendation for the use of the axillary artery as cannulation site.
KW - Aorta, Thoracic/surgery
KW - Arteries
KW - Axilla/blood supply
KW - Catheterization
KW - Extracorporeal Circulation/methods
KW - Femoral Artery
KW - Humans
U2 - 10.1016/j.athoracsur.2006.10.068
DO - 10.1016/j.athoracsur.2006.10.068
M3 - SCORING: Review article
C2 - 17307506
VL - 83
SP - 1219
EP - 1224
JO - ANN THORAC SURG
JF - ANN THORAC SURG
SN - 0003-4975
IS - 3
ER -