Innominate vs. Axillary Artery Cannulation in Aortic Surgery: a Systematic Review and Meta-Analysis

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 34; no. 2; pp. 213 - 221
• Main Authors: Harky, Amer, Chan, Jeffrey Sk, Bithas, Christiana, Hof, Alexander, Sharif, Monira, Froghi, Saied, Bashir, Mohamad
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2019
• Subjects: Aneurysms; Aorta, Thoracic - surgery; Axillary Artery; Axillary Artery - surgery; Brachiocephalic Trunk - surgery; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiology; Catheterization - adverse effects; Catheterization - methods; Catheterization - mortality; Clinical outcomes; Coronary vessels; Dissecting Aneurysm - Surgery; Dissection; Female; Full text; Heart surgery; Hospital Mortality; Humans; Male; Meta-analysis; Mortality; Patients; Peripheral Catherization - Methods; Postoperative Complications; Quality; Review; Studies; Surgeons; SURGERY; Systematic review; Thoracic Surgical Procedures; Treatment Outcome; Treatment Outcomes; Veins & arteries; United States > US; Dissecting Aneurysm - Surgery; Axillary Artery; Treatment Outcomes; Thoracic Surgical Procedures; Peripheral Catherization - Methods
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2018-0272

To investigate whether axillary artery cannulation has supremacy over innominate artery cannulation in thoracic aortic surgery. A comprehensive search was undertaken among the four major databases (PubMed, Excerpta Medica dataBASE [EMBASE], Scopus, and Ovid) to identify all randomized and nonrandomized controlled trials comparing axillary to innominate artery cannulation in thoracic aortic surgery. Databases were evaluated and assessed up to March 2017. Only three studies fulfilled the criteria for this meta-analysis, including 534 patients. Cardiopulmonary bypass time was significantly shorter in the innominate group (P=0.004). However, the innominate group had significantly higher risk of prolonged intubation > 48 hours (P=0.04) than the axillary group. Further analysis revealed no significant difference between the innominate and axillary groups for deep hypothermic circulatory arrest time (P=0.06). The relative risks for temporary and permanent neurological deficits as well as in-hospital mortality were not significantly different for both groups (P=0.90, P=0.49, and P=0.55, respectively). Length of hospital stay was similar for both groups. There is no superiority of axillary over innominate artery cannulation in thoracic aortic surgery in terms of perioperative outcomes; however, as the studies were limited, larger scale comparative studies are required to provide a solid evidence base for choosing optimal arterial cannulation site.