Comparative Study Of Femoral Artery Cannulation And Axillary Artery Cannulation In Stanford Type A Aortic Dissection

Objective: This study was aimed at evaluating the safety and efficacy of femoral artery cannulation through retrospectively compared outcomes between patients with axillary and femoral artery cannulation during open aortic arch repair for type A aortic dissection(TAAD).Methods: 646 patients of TAAD,who underwent open aortic arch repair assisted by extracorporeal circulation in Guangdong Provincial People’s Hospital from January2014 to January 2019,were divided into axillary artery group(n=558)and femoral artery group(n=88).The preoperative,intraoperative and postoperative data of patients were collected to analyze the influence of different cannulation methods on the prognosis of patients.To adjust baseline differences,the axillary artery group was matched to the femoral artery group with propensity score of 1:1.Results: Through propensity score matching,two groups of patients with comparable characteristics were obtained.It was found that hospital mortality(10.6%vs.14.1%,P=0.642)and stroke(3.5% vs.5.9%,P=0.720)were not significantly different between the axillary artery group and the femoral artery group.The incidence of newly required dialysis in the femoral artery group was lower,but the difference was not statistically significant(34.1% vs.20.0%,P=0.050).There were no significant differences among other major events with adverse outcomes.Conclusion: For TAAD patients underwent open aortic arch repair,the perioperative outcomes of femoral artery cannulation and axillary artery cannulation are similar.The femoral artery can be used as a safe and effective alternative to the axillary artery for arterial cannulation.