Advantages of upper brachial artery cannulation in aortic surgery
Background The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial c...
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| Veröffentlicht in: | Asian cardiovascular & thoracic annals 2014-01, Vol.22 (1), p.18-24 |
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| creator | Yilmazkaya, Bayram Gurkahraman, Sami Yondem, Omer Zuhtu Hijazi, Alaa Algin, Ibrahim H Yesilay, Aytekin |
| description | Background
The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings. The aim of this study was to investigate the local neurological and vascular complications following upper brachial cannulation.
Methods and results
This study included 44 patients who underwent procedures on the ascending aorta, aortic arch, or descending aorta with upper brachial artery cannulation for cardiopulmonary bypass at OSM Ortadogu Hospital and Cankaya Hospital between January 2009 and April 2012. The mean age of the 32 (72.7%) men and 12 (27.3%) women was 55.2 ± 12.3 years. Doppler analysis of the upper brachial artery was performed in 26 (59%) patients. Mean follow-up time for Doppler analysis was 5.7 ± 2 months. The mean antegrade cerebral perfusion time was 35 ± 16.1 min. The mean degree of hypothermia was 25.1 ℃ ± 2.0 ℃. Hospital death occurred in 4 (9.1%) patients, and 2 (4.5%) suffered local neurologic complications. Electromyelography analysis was carried out in the 2 patients who suffered local neurologic symptoms.
Conclusions
Brachial artery cannulation is technically simple and less time consuming, thus suitable even for emergency cases. With an acceptable risk of local complications, we recommend routine use of upper brachial cannulation for antegrade cerebral perfusion. |
| doi_str_mv | 10.1177/0218492312467540 |
| format | Article |
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The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings. The aim of this study was to investigate the local neurological and vascular complications following upper brachial cannulation.
Methods and results
This study included 44 patients who underwent procedures on the ascending aorta, aortic arch, or descending aorta with upper brachial artery cannulation for cardiopulmonary bypass at OSM Ortadogu Hospital and Cankaya Hospital between January 2009 and April 2012. The mean age of the 32 (72.7%) men and 12 (27.3%) women was 55.2 ± 12.3 years. Doppler analysis of the upper brachial artery was performed in 26 (59%) patients. Mean follow-up time for Doppler analysis was 5.7 ± 2 months. The mean antegrade cerebral perfusion time was 35 ± 16.1 min. The mean degree of hypothermia was 25.1 ℃ ± 2.0 ℃. Hospital death occurred in 4 (9.1%) patients, and 2 (4.5%) suffered local neurologic complications. Electromyelography analysis was carried out in the 2 patients who suffered local neurologic symptoms.
Conclusions
Brachial artery cannulation is technically simple and less time consuming, thus suitable even for emergency cases. With an acceptable risk of local complications, we recommend routine use of upper brachial cannulation for antegrade cerebral perfusion.</description><identifier>ISSN: 0218-4923</identifier><identifier>EISSN: 1816-5370</identifier><identifier>DOI: 10.1177/0218492312467540</identifier><identifier>PMID: 24585638</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Adult ; Aged ; Aorta, Thoracic - diagnostic imaging ; Aorta, Thoracic - physiopathology ; Aorta, Thoracic - surgery ; Brachial Artery - diagnostic imaging ; Cardiopulmonary Bypass - adverse effects ; Cardiopulmonary Bypass - methods ; Cardiopulmonary Bypass - mortality ; Catheterization, Peripheral - adverse effects ; Catheterization, Peripheral - methods ; Catheterization, Peripheral - mortality ; Cerebrovascular Circulation ; Female ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Patient Selection ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Turkey ; Ultrasonography, Doppler ; Vascular Surgical Procedures - adverse effects ; Vascular Surgical Procedures - mortality</subject><ispartof>Asian cardiovascular & thoracic annals, 2014-01, Vol.22 (1), p.18-24</ispartof><rights>The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c252t-5816a5a3698a64882a8206e98c5296f2aab4a5e1ef1235f1d8a46fb557a33de53</citedby><cites>FETCH-LOGICAL-c252t-5816a5a3698a64882a8206e98c5296f2aab4a5e1ef1235f1d8a46fb557a33de53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0218492312467540$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0218492312467540$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24585638$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yilmazkaya, Bayram</creatorcontrib><creatorcontrib>Gurkahraman, Sami</creatorcontrib><creatorcontrib>Yondem, Omer Zuhtu</creatorcontrib><creatorcontrib>Hijazi, Alaa</creatorcontrib><creatorcontrib>Algin, Ibrahim H</creatorcontrib><creatorcontrib>Yesilay, Aytekin</creatorcontrib><title>Advantages of upper brachial artery cannulation in aortic surgery</title><title>Asian cardiovascular & thoracic annals</title><addtitle>Asian Cardiovasc Thorac Ann</addtitle><description>Background
The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings. The aim of this study was to investigate the local neurological and vascular complications following upper brachial cannulation.
Methods and results
This study included 44 patients who underwent procedures on the ascending aorta, aortic arch, or descending aorta with upper brachial artery cannulation for cardiopulmonary bypass at OSM Ortadogu Hospital and Cankaya Hospital between January 2009 and April 2012. The mean age of the 32 (72.7%) men and 12 (27.3%) women was 55.2 ± 12.3 years. Doppler analysis of the upper brachial artery was performed in 26 (59%) patients. Mean follow-up time for Doppler analysis was 5.7 ± 2 months. The mean antegrade cerebral perfusion time was 35 ± 16.1 min. The mean degree of hypothermia was 25.1 ℃ ± 2.0 ℃. Hospital death occurred in 4 (9.1%) patients, and 2 (4.5%) suffered local neurologic complications. Electromyelography analysis was carried out in the 2 patients who suffered local neurologic symptoms.
Conclusions
Brachial artery cannulation is technically simple and less time consuming, thus suitable even for emergency cases. With an acceptable risk of local complications, we recommend routine use of upper brachial cannulation for antegrade cerebral perfusion.</description><subject>Adult</subject><subject>Aged</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aorta, Thoracic - physiopathology</subject><subject>Aorta, Thoracic - surgery</subject><subject>Brachial Artery - diagnostic imaging</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>Cardiopulmonary Bypass - methods</subject><subject>Cardiopulmonary Bypass - mortality</subject><subject>Catheterization, Peripheral - adverse effects</subject><subject>Catheterization, Peripheral - methods</subject><subject>Catheterization, Peripheral - mortality</subject><subject>Cerebrovascular Circulation</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Turkey</subject><subject>Ultrasonography, Doppler</subject><subject>Vascular Surgical Procedures - adverse effects</subject><subject>Vascular Surgical Procedures - mortality</subject><issn>0218-4923</issn><issn>1816-5370</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDtPwzAUhS0EoqGwMyGPLAG_44xVxUuqxAKzdeM4JVWaBDtG6r_HVQsDEtMdzkP3fAhdU3JHaVHcE0a1KBmnTKhCCnKCMqqpyiUvyCnK9nK-12foIoQNIYRTrs_RjAmppeI6Q4tF_QX9BGsX8NDgOI7O48qD_Wihw-An53fYQt_HDqZ26HHbYxj81Focol8n9RKdNdAFd3W8c_T--PC2fM5Xr08vy8Uqt0yyKZfpL5DAValBCa0ZaEaUK7WVrFQNA6gESEddQxmXDa01CNVUUhbAee0kn6PbQ-_oh8_owmS2bbCu66B3QwyGSiJo2lUWyUoOVuuHELxrzOjbLfidocTswZm_4FLk5tgeq62rfwM_pJIhPxhCYmU2Q_R9Wvt_4TeAtHRj</recordid><startdate>201401</startdate><enddate>201401</enddate><creator>Yilmazkaya, Bayram</creator><creator>Gurkahraman, Sami</creator><creator>Yondem, Omer Zuhtu</creator><creator>Hijazi, Alaa</creator><creator>Algin, Ibrahim H</creator><creator>Yesilay, Aytekin</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201401</creationdate><title>Advantages of upper brachial artery cannulation in aortic surgery</title><author>Yilmazkaya, Bayram ; Gurkahraman, Sami ; Yondem, Omer Zuhtu ; Hijazi, Alaa ; Algin, Ibrahim H ; Yesilay, Aytekin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c252t-5816a5a3698a64882a8206e98c5296f2aab4a5e1ef1235f1d8a46fb557a33de53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aorta, Thoracic - physiopathology</topic><topic>Aorta, Thoracic - surgery</topic><topic>Brachial Artery - diagnostic imaging</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>Cardiopulmonary Bypass - methods</topic><topic>Cardiopulmonary Bypass - mortality</topic><topic>Catheterization, Peripheral - adverse effects</topic><topic>Catheterization, Peripheral - methods</topic><topic>Catheterization, Peripheral - mortality</topic><topic>Cerebrovascular Circulation</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Turkey</topic><topic>Ultrasonography, Doppler</topic><topic>Vascular Surgical Procedures - adverse effects</topic><topic>Vascular Surgical Procedures - mortality</topic><toplevel>online_resources</toplevel><creatorcontrib>Yilmazkaya, Bayram</creatorcontrib><creatorcontrib>Gurkahraman, Sami</creatorcontrib><creatorcontrib>Yondem, Omer Zuhtu</creatorcontrib><creatorcontrib>Hijazi, Alaa</creatorcontrib><creatorcontrib>Algin, Ibrahim H</creatorcontrib><creatorcontrib>Yesilay, Aytekin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Asian cardiovascular & thoracic annals</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yilmazkaya, Bayram</au><au>Gurkahraman, Sami</au><au>Yondem, Omer Zuhtu</au><au>Hijazi, Alaa</au><au>Algin, Ibrahim H</au><au>Yesilay, Aytekin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advantages of upper brachial artery cannulation in aortic surgery</atitle><jtitle>Asian cardiovascular & thoracic annals</jtitle><addtitle>Asian Cardiovasc Thorac Ann</addtitle><date>2014-01</date><risdate>2014</risdate><volume>22</volume><issue>1</issue><spage>18</spage><epage>24</epage><pages>18-24</pages><issn>0218-4923</issn><eissn>1816-5370</eissn><abstract>Background
The best method of cerebral protection during aortic arch surgery remains controversial. However, antegrade cerebral perfusion seems to be the most favorable because of better neurological outcomes. Although there have been many studies on antegrade cerebral perfusion via upper brachial cannulation, there is a lack of studies focusing particularly on local complications, with objective findings. The aim of this study was to investigate the local neurological and vascular complications following upper brachial cannulation.
Methods and results
This study included 44 patients who underwent procedures on the ascending aorta, aortic arch, or descending aorta with upper brachial artery cannulation for cardiopulmonary bypass at OSM Ortadogu Hospital and Cankaya Hospital between January 2009 and April 2012. The mean age of the 32 (72.7%) men and 12 (27.3%) women was 55.2 ± 12.3 years. Doppler analysis of the upper brachial artery was performed in 26 (59%) patients. Mean follow-up time for Doppler analysis was 5.7 ± 2 months. The mean antegrade cerebral perfusion time was 35 ± 16.1 min. The mean degree of hypothermia was 25.1 ℃ ± 2.0 ℃. Hospital death occurred in 4 (9.1%) patients, and 2 (4.5%) suffered local neurologic complications. Electromyelography analysis was carried out in the 2 patients who suffered local neurologic symptoms.
Conclusions
Brachial artery cannulation is technically simple and less time consuming, thus suitable even for emergency cases. With an acceptable risk of local complications, we recommend routine use of upper brachial cannulation for antegrade cerebral perfusion.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>24585638</pmid><doi>10.1177/0218492312467540</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aorta, Thoracic - diagnostic imaging Aorta, Thoracic - physiopathology Aorta, Thoracic - surgery Brachial Artery - diagnostic imaging Cardiopulmonary Bypass - adverse effects Cardiopulmonary Bypass - methods Cardiopulmonary Bypass - mortality Catheterization, Peripheral - adverse effects Catheterization, Peripheral - methods Catheterization, Peripheral - mortality Cerebrovascular Circulation Female Hospital Mortality Humans Male Middle Aged Patient Selection Postoperative Complications - etiology Postoperative Complications - mortality Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome Turkey Ultrasonography, Doppler Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - mortality |
| title | Advantages of upper brachial artery cannulation in aortic surgery |
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