Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery

Abstract Objective To compare the application and outcomes of femoral versus axillary arterial cannulation in adult patients undergoing surgery for type A aortic dissection. Methods We conducted a retrospective review of 108 patients who underwent surgery for type A aortic dissection, dividing them...

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Main Authors: ZhenHong Wang, YiHui Yu, XinYi Xie, LinLin Wan, Lei Wang, JiaLin Yin
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:https://doi.org/10.1186/s13019-025-03465-z
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author ZhenHong Wang
YiHui Yu
XinYi Xie
LinLin Wan
Lei Wang
JiaLin Yin
author_facet ZhenHong Wang
YiHui Yu
XinYi Xie
LinLin Wan
Lei Wang
JiaLin Yin
author_sort ZhenHong Wang
collection DOAJ
description Abstract Objective To compare the application and outcomes of femoral versus axillary arterial cannulation in adult patients undergoing surgery for type A aortic dissection. Methods We conducted a retrospective review of 108 patients who underwent surgery for type A aortic dissection, dividing them into two groups based on the type of arterial cannulation utilized: the femoral artery cannulation group (n = 53) and the axillary artery cannulation group (n = 55). We assessed their general condition, cardiopulmonary bypass time, and the occurrence of major postoperative complications. Multivariate logistic regression models were used to identify independent predictors of mortality risk factors. Results The operative mortality rates were comparable between the two groups, with axillary cannulation at 18.1% and femoral cannulation at 15.1%. Multivariate logistic analysis identified age (70 years or older) and prolonged extracorporeal cardiopulmonary bypass time (250 min or more) as independent risk factors for surgical mortality. The rates of early stroke, renal injury, and cognitive dysfunction were similar in both groups. Conclusion The findings indicate that femoral and axillary arterial cannulation yield similar outcomes in patients with acute type A aortic dissection. The choice of cannulation site should be individualized based on each patient’s specific risk factors. Additionally, preoperative hemodynamic instability, the duration of cardiopulmonary bypass (CPB), and a high body mass index (BMI ≥ 30 kg/m²) are independent predictors of operative mortality.
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spelling doaj-art-5939e50dab844d6b816b8e90ad33fd1a2025-08-20T03:43:30ZengBMCJournal of Cardiothoracic Surgery1749-80902025-05-012011510.1186/s13019-025-03465-zComparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgeryZhenHong Wang0YiHui Yu1XinYi Xie2LinLin Wan3Lei Wang4JiaLin Yin5Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Cardiology, Nanjing First Hospital of Nanjing Medical UniversityDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Echocardiography, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical UniversityAbstract Objective To compare the application and outcomes of femoral versus axillary arterial cannulation in adult patients undergoing surgery for type A aortic dissection. Methods We conducted a retrospective review of 108 patients who underwent surgery for type A aortic dissection, dividing them into two groups based on the type of arterial cannulation utilized: the femoral artery cannulation group (n = 53) and the axillary artery cannulation group (n = 55). We assessed their general condition, cardiopulmonary bypass time, and the occurrence of major postoperative complications. Multivariate logistic regression models were used to identify independent predictors of mortality risk factors. Results The operative mortality rates were comparable between the two groups, with axillary cannulation at 18.1% and femoral cannulation at 15.1%. Multivariate logistic analysis identified age (70 years or older) and prolonged extracorporeal cardiopulmonary bypass time (250 min or more) as independent risk factors for surgical mortality. The rates of early stroke, renal injury, and cognitive dysfunction were similar in both groups. Conclusion The findings indicate that femoral and axillary arterial cannulation yield similar outcomes in patients with acute type A aortic dissection. The choice of cannulation site should be individualized based on each patient’s specific risk factors. Additionally, preoperative hemodynamic instability, the duration of cardiopulmonary bypass (CPB), and a high body mass index (BMI ≥ 30 kg/m²) are independent predictors of operative mortality.https://doi.org/10.1186/s13019-025-03465-zType a aortic dissection surgeryCannulationOutcomeFemoral arterialAxillary arterial
spellingShingle ZhenHong Wang
YiHui Yu
XinYi Xie
LinLin Wan
Lei Wang
JiaLin Yin
Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery
Journal of Cardiothoracic Surgery
Type a aortic dissection surgery
Cannulation
Outcome
Femoral arterial
Axillary arterial
title Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery
title_full Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery
title_fullStr Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery
title_full_unstemmed Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery
title_short Comparison of outcomes between axillary and femoral artery cannulation for type A aortic dissection surgery
title_sort comparison of outcomes between axillary and femoral artery cannulation for type a aortic dissection surgery
topic Type a aortic dissection surgery
Cannulation
Outcome
Femoral arterial
Axillary arterial
url https://doi.org/10.1186/s13019-025-03465-z
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