IMR Press / RCM / Volume 25 / Issue 5 / DOI: 10.31083/j.rcm2505156
Open Access Systematic Review
Central (Aortic) Cannulation versus Peripheral (Axillary or Femoral) Cannulation in Acute Type A Aortic Dissections: A Meta-Analysis of Comparative Studies
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1 Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, 100054 Beijing, China
*Correspondence: dxqzwxm@163.com (Xiaomeng Wang); xt.hou@ccmu.edu.cn (Xiaotong Hou)
Rev. Cardiovasc. Med. 2024, 25(5), 156; https://doi.org/10.31083/j.rcm2505156
Submitted: 19 October 2023 | Revised: 8 December 2023 | Accepted: 20 December 2023 | Published: 6 May 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: There has been an increased interest in using antegrade cannulation techniques during surgery for type A aortic dissection. While the utilization of central artery cannulation has been on the rise in recent times, its effectiveness and safety still require thorough examination. This study aimed to explore both the efficiency and safety of central arterial cannulation. Methods: A meta-analysis was conducted on studies that evaluated surgical outcomes when using central artery cannulation (CAC) in comparison to axillary artery cannulation (AXC) or femoral artery cannulation (FAC). Results: 10 retrospective observational studies were included, enrolling 3022 patients (CAC = 1208 vs. FAC = 606; CAC = 1051 vs. AXC = 1119). Among these, 4 articles involved axillary artery cannulation, femoral artery cannulation, and central artery cannulation. Central cannulation was linked to decreased short-term mortality [odds ratio, 0.66, 95% confidence interval (CI) (0.48, 0.89), χ2 = 3.27, p = 0.007; I2 = 0; p = 0.86] compared to femoral cannulation. Additionally, central cannulation was associated with a lower occurrence of temporary neurological dysfunction (TND) [odds ratio, 0.57, 95% CI (0.38, 0.85), χ2 = 0.88, p = 0.006; I2 = 0%, p = 0.83] when compared with femoral cannulation. However, there was no statistical significance in mortality and TND between the central cannulation and axillary cannulation groups. Conclusions: This meta-analysis reveals that central cannulation surpasses femoral cannulation in lowering short-term mortality and the occurrence of TND among patients undergoing surgery for type A acute aortic dissection. However, central cannulation does not exhibit a higher mortality and TND compared to axillary cannulation.

Keywords
type A aortic dissection
aortic cannulation
femoral cannulation
axillary cannulation
stroke
temporary neurological dysfunction
Funding
82170400/National Nature Science Foundation of China
National clinical key specialty construction project
YESS20220335/China Association for Science and Technology “Young Talent Lifting Project”
Figures
Fig. 1.
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