The following is a summary of “Femoral artery cannulation increases the risk of postoperative stroke in patients with acute DeBakey I aortic dissection,” published in the October 2023  issue of Thoracic and Cardiovascular Surgery by Wang, et al.

Patients diagnosed with DeBakey I acute aortic dissection have a higher risk of experiencing a stroke after surgery if a certain arterial cannulation location is used rather than another. The purpose of this research was to determine the most effective method of arterial cannulation for these individuals. At tertiary centers throughout the country, a total of 1,514 patients diagnosed with DeBakey I acute aortic dissection underwent frozen elephant trunk and complete arch replacement between January 2009 and 2019. They were separated into two groups: one that underwent cannulation of the axillary artery exclusively (n = 1075) and another that had cannulation of the femoral artery (n = 439)—comparing the prognosis required first taking into account the variations in the patient’s baseline conditions via the use of propensity score matching. 

In the group that had cannulation of the femoral artery, the incidence of stroke and acute brain infarction was significantly greater than that of the group that underwent cannulation of the axillary artery exclusively (stroke, 11.7% vs. 7.0%, P =.03; acute brain infarction, 6.0% vs. 2.7%, P<.01). The group that underwent cannulation of the femoral artery was then subdivided into two groups: one group underwent cannulation of the femoral artery alone (n = 106), while the other group had cannulation of the axillary coupled with the femoral artery (n = 333). The comparison was made between the group that had their axillary artery cannulated and their femoral artery and the group that had just their axillary artery cannulated. 

After propensity score matching, the incidence of stroke and acute brain infarction was greater in the group that received cannulation of the axillary coupled with femoral artery than in the group that received cannulation of the axillary artery alone (stroke, 13.5% vs. 7.2%, P<.01; acute brain infarction, 6.9% vs. 2.5%, P<.01). This was the case for both stroke and acute brain infarction. It is advised that just the axillary artery be cannulated as the best arterial cannulation method for the majority of patients who have been diagnosed with DeBakey I acute aortic dissection. It is not suggested to perform cannulation of the axillary artery in conjunction with cannulation of the femoral artery on individuals who are not candidates for cannulation of the axillary artery alone.

Source: sciencedirect.com/science/article/abs/pii/S0022522322000290