Alternatives for arterial inflow in open surgical descending and thoracoabdominal aortic repair

Surgical repair of the descending and thoracoabdominal aorta is regularly performed with the support of extracorporeal circulation. Femoral artery cannulation is the standard for arterial inflow, but presents, along with extremity hypoperfusion, the risk of embolization and malperfusion with retrograde aortic perfusion. There are alternatives for arterial inflow to avoid the drawbacks of the standard approach while accommodating different perfusion strategies. Ideally, with a broadened perfusion armamentarium, the choice of arterial inflow could be individualized to provide safe and efficient extracorporeal circulation.