Comparison of the effects of femoral and axillary artery cannulation on ischemic cerebral injury in acute type A aortic dissection surgery: A retrospective study
DOI: https://doi.org/10.20528/cjpm.2024.03.006
View Counter: Abstract | 140 times | ‒ Full Article | 39 times |
Full Text:
PDFAbstract
Background: Acute Type A Aortic Dissection (ATAAD) is a life-threatening condition requiring emergency surgical intervention. This retrospective study evaluates the impact of femoral and axillary arterial cannulation techniques on ischemic neurological damage and mortality.
Materials and Method: A total of 60 patients who underwent emergency surgery for ATAAD between 2016 and 2021 were analyzed. Patients were divided into two groups based on the arterial cannulation technique: Group A (axillary cannulation) and Group F (femoral cannulation). Preoperative, intraoperative, and postoperative variables were compared between the groups. The primary outcome was incidence of ischemic cerebral injury and secondary outcomes included 30-day all-cause mortality, intensive care unit and hospital length of stay and postoperative complications.
Results: There were no statistically significant differences between the two groups in terms of ischemic cerebral injury (p=0.13). There was no significant difference in 30-day mortality between the groups (p= 0.27). Logistic regression analysis revealed that the cannulation type was a risk factor for ischemic cerebral injury development (OR [95% CI]; 119.034 [1.612–8791.314], p=0.029).
Conclusions: Our findings indicate that the type of cannulation may be a risk factor for the development of ischemic cerebral injury. Further studies are needed to determine the optimal arterial cannulation technique for improving outcomes in ATAAD surgery.
Keywords
References
Vignaraja V, Sharma S, Dindyal S. Acute Aortic Syndrome. 2024 Oct 6. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
Foundation ACoC, Guidelines AHATFoP, Surgery AAfT, Radiology ACo, Association AS, Anesthesiologists SoC, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease. J Am Coll Cardiol. 2010;55(14):e27-e129.
Conzelmann LO, Weigang E, Mehlhorn U, Abugameh A, Hoffmann I, Blettner M, et al. Mortality in patients with acute aortic dissection type A: analysis of pre-and intraoperative risk factors from the German Registry for Acute Aortic Dissection Type A (GERAADA). Oxford University Press; 2016.
Lin C-Y, Tung T-H, Wu M-Y, Tseng C-N, Tsai F-C. Surgical outcomes of DeBakey type I and type II acute aortic dissection: a propensity score-matched analysis in 599 patients. J Cardiothorac Surg. 2021;16(1):1-9.
Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): New insights into an old disease. JAMA. 2000;283(7):897–903.
Suzuki T, Asai T, Matsubayashi K, Kambara A, Kinoshita T, Hiramatsu N, Nishimura O. Safety and efficacy of central cannulation through ascending aorta for type A aortic dissection. Interact Cardiovasc Thorac Surg. 2010;11(1):34-7.
Xia Q, Cao Y, Xie B, Qiu D, Deng L, Wang M, Han H. Cannulation strategies in type A aortic dissection: a novel insight narrative review. J Thorac Dis. 2021;13(4):2551-2562.
Etz CD, von Aspern K, da Rocha E Silva J, Girrbach FF, Leontyev S, Luehr M, Misfeld M, Borger MA, Mohr FW. Impact of perfusion strategy on outcome after repair for acute type a aortic dissection. Ann Thorac Surg. 2014;97(1):78-85.
Gokalp O, Yilik L, Iner H, Yesilkaya NK, Besir Y, Iscan S, Eygi B, Gurbuz A. Comparison of Femoral and Axillary Artery Cannulation in Acute Type A Aortic Dissection Surgery. Braz J Cardiovasc Surg. 2020;35(1):28-33.
Ren Z, Wang Z, Hu R, Wu H, Deng H, Zhou Z, Hu X, Jiang W. Which cannulation (axillary cannulation or femoral cannulation) is better for acute type A aortic dissection repair? A meta-analysis of nine clinical studies. Eur J Cardiothorac Surg. 2015;47(3):408-15.
Refbacks
- There are currently no refbacks.