The impact of arterial cannulation strategy on operative outcomes in aortic surgery

Evidence from a comprehensive meta-analysis of comparative studies on 4476 patients

Umberto Benedetto, Shahzad G. Raja, Mohamed Amrani, John R. Pepper, Mohamed Zeinah, Euclide Tonelli, Giuseppe Biondi-Zoccai, Giacomo Frati

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objectives There is a growing perception that peripheral cannulation through the femoral artery, by reversing the flow in the thoracoabdominal aorta, may increase the risk of retrograde brain embolization in aortic surgery. Central cannulation sites, including the right axillary artery, have been reported to improve operative outcomes by allowing antegrade blood flow. However, peripheral cannulation still remains largely used because a consensus for the routine use of central cannulation approaches has not been reached.

Results A total of 4476 patients were included in the final analysis. Central cannulation was used in 2797 patients, and peripheral cannulation was used in 1679 patients. Central cannulation showed a protective effect on in-hospital mortality (risk ratio, 0.59; 95% confidence interval, 0.48-0.7; P 2 = 0%).

Conclusions Central cannulation was superior to peripheral cannulation in reducing in-hospital mortality and the incidence of permanent neurologic deficit. This superiority was particularly evident when the axillary artery was used for central cannulation.

Original languageEnglish
Pages (from-to)2936-2943
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume148
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

Fingerprint

Catheterization
Meta-Analysis
Axillary Artery
Hospital Mortality
Femoral Artery
Neurologic Manifestations
Aorta
Odds Ratio
Confidence Intervals
Incidence
Brain

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

The impact of arterial cannulation strategy on operative outcomes in aortic surgery : Evidence from a comprehensive meta-analysis of comparative studies on 4476 patients. / Benedetto, Umberto; Raja, Shahzad G.; Amrani, Mohamed; Pepper, John R.; Zeinah, Mohamed; Tonelli, Euclide; Biondi-Zoccai, Giuseppe; Frati, Giacomo.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 148, No. 6, 01.12.2014, p. 2936-2943.

Research output: Contribution to journalArticle

Benedetto, Umberto ; Raja, Shahzad G. ; Amrani, Mohamed ; Pepper, John R. ; Zeinah, Mohamed ; Tonelli, Euclide ; Biondi-Zoccai, Giuseppe ; Frati, Giacomo. / The impact of arterial cannulation strategy on operative outcomes in aortic surgery : Evidence from a comprehensive meta-analysis of comparative studies on 4476 patients. In: Journal of Thoracic and Cardiovascular Surgery. 2014 ; Vol. 148, No. 6. pp. 2936-2943.
@article{e832b2df1567469cad46af90dc24e258,
title = "The impact of arterial cannulation strategy on operative outcomes in aortic surgery: Evidence from a comprehensive meta-analysis of comparative studies on 4476 patients",
abstract = "Objectives There is a growing perception that peripheral cannulation through the femoral artery, by reversing the flow in the thoracoabdominal aorta, may increase the risk of retrograde brain embolization in aortic surgery. Central cannulation sites, including the right axillary artery, have been reported to improve operative outcomes by allowing antegrade blood flow. However, peripheral cannulation still remains largely used because a consensus for the routine use of central cannulation approaches has not been reached.Results A total of 4476 patients were included in the final analysis. Central cannulation was used in 2797 patients, and peripheral cannulation was used in 1679 patients. Central cannulation showed a protective effect on in-hospital mortality (risk ratio, 0.59; 95{\%} confidence interval, 0.48-0.7; P 2 = 0{\%}).Conclusions Central cannulation was superior to peripheral cannulation in reducing in-hospital mortality and the incidence of permanent neurologic deficit. This superiority was particularly evident when the axillary artery was used for central cannulation.",
author = "Umberto Benedetto and Raja, {Shahzad G.} and Mohamed Amrani and Pepper, {John R.} and Mohamed Zeinah and Euclide Tonelli and Giuseppe Biondi-Zoccai and Giacomo Frati",
year = "2014",
month = "12",
day = "1",
doi = "10.1016/j.jtcvs.2014.05.082",
language = "English",
volume = "148",
pages = "2936--2943",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - The impact of arterial cannulation strategy on operative outcomes in aortic surgery

T2 - Evidence from a comprehensive meta-analysis of comparative studies on 4476 patients

AU - Benedetto, Umberto

AU - Raja, Shahzad G.

AU - Amrani, Mohamed

AU - Pepper, John R.

AU - Zeinah, Mohamed

AU - Tonelli, Euclide

AU - Biondi-Zoccai, Giuseppe

AU - Frati, Giacomo

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Objectives There is a growing perception that peripheral cannulation through the femoral artery, by reversing the flow in the thoracoabdominal aorta, may increase the risk of retrograde brain embolization in aortic surgery. Central cannulation sites, including the right axillary artery, have been reported to improve operative outcomes by allowing antegrade blood flow. However, peripheral cannulation still remains largely used because a consensus for the routine use of central cannulation approaches has not been reached.Results A total of 4476 patients were included in the final analysis. Central cannulation was used in 2797 patients, and peripheral cannulation was used in 1679 patients. Central cannulation showed a protective effect on in-hospital mortality (risk ratio, 0.59; 95% confidence interval, 0.48-0.7; P 2 = 0%).Conclusions Central cannulation was superior to peripheral cannulation in reducing in-hospital mortality and the incidence of permanent neurologic deficit. This superiority was particularly evident when the axillary artery was used for central cannulation.

AB - Objectives There is a growing perception that peripheral cannulation through the femoral artery, by reversing the flow in the thoracoabdominal aorta, may increase the risk of retrograde brain embolization in aortic surgery. Central cannulation sites, including the right axillary artery, have been reported to improve operative outcomes by allowing antegrade blood flow. However, peripheral cannulation still remains largely used because a consensus for the routine use of central cannulation approaches has not been reached.Results A total of 4476 patients were included in the final analysis. Central cannulation was used in 2797 patients, and peripheral cannulation was used in 1679 patients. Central cannulation showed a protective effect on in-hospital mortality (risk ratio, 0.59; 95% confidence interval, 0.48-0.7; P 2 = 0%).Conclusions Central cannulation was superior to peripheral cannulation in reducing in-hospital mortality and the incidence of permanent neurologic deficit. This superiority was particularly evident when the axillary artery was used for central cannulation.

UR - http://www.scopus.com/inward/record.url?scp=84920148702&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920148702&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2014.05.082

DO - 10.1016/j.jtcvs.2014.05.082

M3 - Article

VL - 148

SP - 2936

EP - 2943

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 6

ER -