Direct Axillary Arterial Cannulation Using Seldinger's Technique in Aortic Dissection.

Area of Science:

• Cardiovascular Surgery
• Vascular Access
• Aortic Surgery

Background:

• The axillary artery is a common access point for cardiopulmonary bypass, particularly in cases of acute aortic dissection.
• Two primary cannulation methods exist: using a side graft or direct Seldinger's technique.
• Assessing complications of these techniques is crucial for patient safety.

Purpose of the Study:

• To evaluate and compare the technical challenges and complications associated with axillary artery cannulation using a side graft versus direct Seldinger's technique.

Main Methods:

• A retrospective study of 53 patients undergoing axillary artery cannulation for cardiopulmonary bypass between January 2003 and December 2009.
• Patients were divided into two groups: 35 using a side graft and 18 using direct Seldinger's technique.

Main Results:

• Both axillary artery cannulation techniques demonstrated low complication rates.
• One patient (2.9%) in the side graft group and one (5.6%) in the direct group experienced axillary artery damage or dissection.
• No instances of malperfusion, insufficient flow, brachial plexus injury, compartment syndrome, or local wound infection were reported.

Conclusions:

• Axillary artery cannulation for cardiopulmonary bypass is associated with rare technical problems and complications, regardless of the technique used.
• Direct Seldinger's technique offers a simpler and safer approach compared to the side graft method.
• Both techniques are deemed acceptable, with the choice depending on surgeon preference.