Direct axillary cannulation with open Seldinger-guided technique: is it safe?

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Thoracic Surgery

Background:

• Axillary artery cannulation is a common approach in thoracic aortic surgery, often using a sidearm graft.
• Femoral cannulation is preferred institutionally, but axillary cannulation is used selectively for patients with specific imaging findings.
• The open Seldinger-guided technique has been routinely employed since 2011 for axillary cannulation.

Purpose of the Study:

• To evaluate the safety and efficacy of the open Seldinger-guided technique for axillary artery cannulation.
• To report institutional experience with this specific cannulation method.

Main Methods:

• Retrospective analysis of 404 peripheral arterial cannulations for thoracic aortic surgery (2011-2016).
• Identified 52 axillary cannulations performed using the open Seldinger-guided technique.
• Technique involves surgical exposure and guidewire cannulation without arterial incision.

Main Results:

• Axillary cannulations were performed for ascending and/or arch surgery.
• Hospital survival rate was 98.1% (51/52).
• No axillary arterial injury, intraoperative malperfusion, postoperative limb ischemia, stroke, wound infections, or late pseudoaneurysms were observed.

Conclusions:

• The open Seldinger-guided technique for axillary artery cannulation is safe and effective.
• The technique is recommended due to its speed, simplicity, and reduced risk of complications.
• Preservation of distal arterial flow and minimized arterial manipulation contribute to its favorable safety profile.