Right Axillary Artery Cannulation for Endovascular Repair of an Acute type a Aortic Dissection

2017 ◽  
Vol 12 (2) ◽  
pp. 140-143
Author(s):  
Corbin E. Muetterties ◽  
Jeremy H. Conklin ◽  
G. William Moser ◽  
Grayson H. Wheatley
Keyword(s):  
Aortic Dissection ◽  
Endovascular Repair ◽  
Axillary Artery ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Artery Cannulation

Right Axillary Artery Cannulation for Endovascular Repair of an Acute type a Aortic Dissection

2017 ◽  
Vol 12 (2) ◽  
pp. 140-143 ◽  
Author(s):  
Corbin E. Muetterties ◽  
Jeremy H. Conklin ◽  
G. William Moser ◽  
Grayson H. Wheatley
Keyword(s):  
Aortic Dissection ◽  
Endovascular Repair ◽  
Axillary Artery ◽  
False Lumen ◽  
Type A ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Aortic Repair

We present the case of a 48-year-old woman with an acute type A aortic dissection that was treated with thoracic endovascular aortic repair at our institution. The patient was found to have a focal type A dissection with pericardial effusion but no tamponade physiology and no involvement of the aortic valve or root. We elected to treat the patient's type A aortic dissection with an endovascular stent because of the patient's favorable anatomy and no evidence of neurologic deficits or signs of distal malperfusion. The patient was successfully treated with an abdominal aortic cuff deployed through the axillary artery. An axillary approach was necessary because of the short length of the delivery sheath preventing a transfemoral delivery. At 2-year follow-up, the patient remains free of complications with computed tomography scan revealing complete false lumen thrombosis and a stable endovascular repair. This report demonstrates a case of acute type A aortic dissection successfully treated using thoracic endovascular aortic repair and illustrates the utility of axillary cannulation for precise deployment of stent grafts in the ascending aorta.

scholarly journals Comparison of Femoral and Axillary Artery Cannulation in Acute Type A Aortic Dissection Surgery

2020 ◽  
Vol 35 (1) ◽  
Author(s):  
Orhan Gokalp ◽  
Levent Yilik ◽  
Hasan Iner ◽  
Nihan Karakas Yesilkaya ◽  
Yuksel Besir ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Axillary Artery ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Artery Cannulation

Is Axillary Better Than Femoral Artery Cannulation in Repair of Acute Type A Aortic Dissection?

2019 ◽  
Vol 14 (2) ◽  
pp. 124-133 ◽  
Author(s):  
Eilon Ram ◽  
Yoav Krupik ◽  
Alexander Lipey ◽  
Ami Shinfeld ◽  
Yael Peled ◽  
...  
Keyword(s):  
Renal Failure ◽  
Aortic Dissection ◽  
Femoral Artery ◽  
Operative Mortality ◽  
Axillary Artery ◽  
Type A ◽  
Acute Type ◽  
Complication Rates ◽  
Type A Aortic Dissection ◽  
Artery Cannulation

Objective We compared early and late outcomes of patients who underwent femoral versus axillary artery cannulation for repair of acute type A aortic dissection. Methods Between 2004 and 2017, we retrospectively evaluated the clinical outcomes of 135 consecutive patients who underwent emergency surgery for acute type A aortic dissection repair. Patients were divided into 2 groups: those who underwent femoral ( n = 84) and those who underwent right axillary ( n = 51) artery cannulation. Mean patient age was 63 ± 13 years and 88 (65%) were male. Results Overall operative mortality was 12.6% (axillary 15.7%, femoral 10.7%; P = 0.564). Patients who underwent axillary compared to femoral artery cannulation had a statistically nonsignificant higher operative mortality rate among both stable and unstable patients (13% vs. 6.5%, P = 0.405 and 40% vs. 22.7%, P = 0.818, respectively). While there was no difference in major complication rates, such as stroke, low cardiac output, and surgical revision for bleeding/tamponade, there was a higher incidence of renal failure that required dialysis in patients who underwent axillary cannulation (12% vs. 1%, P = 0.022). Multivariate analysis demonstrated that predictors for the composite endpoint of operative mortality or severe organ malperfusion, such as renal failure or cerebrovascular accident, were hemodynamic instability on admission (OR 3.87; 95% CI, 1.23 to 12.63; P = 0.021), lower preoperative creatinine clearance (OR 0.94; 95% CI, 0.90 to 0.97; P < 0.001); and the use of axillary artery cannulation (OR 4.1; 95% CI, 1.43 to 12.78; P = 0.011). Among those discharged from hospital, the 3-year survival rate was 91% in the axillary group and 87% in the femoral group ( P = 0.772). Conclusions Based on our experience, emergent surgery for both stable and unstable patients with acute type A aortic dissection demonstrated similar survival rates and significantly less renal impairment when using the femoral cannulation approach.

Axillary Artery Cannulation Improves Operative Results for Acute Type A Aortic Dissection

2005 ◽  
Vol 80 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Yoshimasa Moizumi ◽  
Naotaka Motoyoshi ◽  
Kei Sakuma ◽  
Seijiro Yoshida
Keyword(s):  
Aortic Dissection ◽  
Axillary Artery ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Operative Results ◽  
Artery Cannulation

scholarly journals Femoral artery cannulation combined with axillary artery cannulation is safe for Stanford type A aortic dissection

2020 ◽  
Author(s):  
Ling-chen Huang ◽  
Qi-chen Xu ◽  
Dao-zhong Chen ◽  
Xiao-fu Dai ◽  
Liang-wan Chen
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Dissection ◽  
Femoral Artery ◽  
Axillary Artery ◽  
Type A ◽  
Clinical Results ◽  
Type A Aortic Dissection ◽  
Artery Cannulation ◽  
Surgical Data ◽  
Perfusion Time

Abstract Background The optimal cannulation strategy in surgery for Stanford type A aortic dissection is critical to the patients’ survival, but remains controversial. Different cannulation strategies have their own advantages and drawbacks during cardiopulmonary bypass. Our center used femoral and axillary artery cannulation for Stanford type A aortic dissection. The purpose of this study was to review and clarify the clinic outcome of femoral artery cannulation combined with axillary artery cannulation for the treatment of type A aortic dissection. Methods We performed a retrospective study that included 327 patients who were surgically treated for type A aortic dissection in our institution from January 2017 to June 2019.Using femoral and axillary artery cannulation to establish cardiopulmonary bypass in patients with type A aortic dissection. The demographics data and surgical data, clinical results of the patients were calculated. Results Femoral artery combined with axillary artery cannulation was technically successful in 327 patients. The cardiopulmonary bypass time was 141.60 ± 34.89 minutes, and the selective antegrade cerebral perfusion time was 14.94 ± 2.76 minutes. The early mortality was 3.06%. The incidence of permanent neurologic dysfunction was 0.92%. Sixteen patients had post-operative renal insufficiency and five patients with liver failure. Two patients ended up with paraplegia. Conclusion Femoral artery combined with axillary artery cannulation for type A aortic dissection can significantly reduce the occurrence of malperfusion syndrome and nervous system complications, especially for cerebral protection.

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