title: Outcomes of axillary artery side graft cannulation for extracorporeal membrane oxygenation.
abstract: OBJECTIVE
  To determine the safety, efficacy, and frequency of side graft axillary artery cannulation for extracorporeal membrane oxygenation support and compare it with other cannulation techniques.
  
  
  METHODS
  From January 2001 to October 2011, 308 adult patients were supported with extracorporeal membrane oxygenation at a single center. In 81 patients (26.3%), the extracorporeal membrane oxygenation circuit was composed of an arterial inflow by a side graft sewn to the axillary artery. Of the 308 patients, 166 (53.9%) underwent femoral arterial cannulation and 61 (19.8%) underwent ascending aortic cannulation The pertinent variables and postprocedural events were retrospectively analyzed in this cohort of patients.
  
  
  RESULTS
  The most common complication in the axillary artery group was hyperperfusion syndrome of the ipsilateral upper extremity (n = 20, 24.7%), followed by bleeding from the arterial outflow graft (n = 14, 17.3%). Lower extremity ischemia and fasciotomy were more frequent after femoral arterial cannulation (n = 27, 16%, and n = 18, 10.8%, respectively). The predictors for a poor in-hospital outcome for the entire group of patients were age and postoperative cerebral vascular accident. The cannulation method was not a predictor of in-hospital outcomes.
  
  
  CONCLUSIONS
  Extracorporeal membrane oxygenation support with side graft axillary artery technique was more frequently associated with hyperperfusion syndrome than other cannulation sites. Lower extremity ischemia and compartment syndrome was more common after femoral arterial cannulation.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio; National and Kapodistrian, University of Athens, Athens, Greece; Department of Thoracic and Cardiovascular Surgery, Baylor University Medical Center, Dallas, Tex.
authors.forename: Themistokles
authors.initials: T
authors.lastname: Chamogeorgakis
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Brian
authors.initials: B
authors.lastname: Lima
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Baylor University Medical Center, Dallas, Tex.
authors.forename: Alexis E
authors.initials: AE
authors.lastname: Shafii
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Dave
authors.initials: D
authors.lastname: Nagpal
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Pokersnik
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Navia
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio.
authors.forename: David
authors.initials: D
authors.lastname: Mason
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio; Department of Thoracic and Cardiovascular Surgery, Baylor University Medical Center, Dallas, Tex. Electronic address: Gonzo.Gonzalez@baylorhealth.edu.
authors.forename: Gonzalo V
authors.initials: GV
authors.lastname: Gonzalez-Stawinski
mesh_terms: D001366:Axillary Artery / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies