title: Axillary and innominate artery cannulation during surgery of the thoracic aorta: a comparative study.
abstract: OBJECTIVE
  The aim of this paper was to compare hospital outcomes in patients undergoing elective surgery of the thoracic aorta using the right axillary artery (RAA) and the innominate artery (IA) as a cannulation site for cardiopulmonary bypass (CPB) arterial inflow.
  
  
  METHODS
  Between September 2009 and October 2011, 71 patients underwent elective aortic procedures with RAA (N.=27) and IA (N.=44) cannulation. Selection of RAA vs. IA was not randomized, but rather based on surgical judgment of best indication in each patient. Pre-, intra-, and postoperative variables were compared according to cannulation site.
  
  
  RESULTS
  Preoperative comorbidities, underlying aortic pathology, and surgical procedures were similar in RAA and IA patients. Hospital mortality was 11.1% and 6.8% in RAA and IA patients, respectively (P=0.243). Overall, 4 brain infarctions occurred, all left sided (RAA: 3.7% vs. IA: 6.8%; P=0.508). One brachial plexus injury, and 1 arterial dissection occurred in RAA group. No cannulation-related morbidity was observed in IA patients. Theoretical CPB flow could be reached in all patients, but resistances through the cannulation sites were more favourable in IA patients.
  
  
  CONCLUSIONS
  RAA and IA were associated with similarly valid results. The choice between the two, based on the specific patient's characteristics, can improve outcomes after aortic surgery.
authors.affiliation: Cardiovascular Surgery Department Sant'Orsola‑Malpighi Hospital, Bologna UniversityBologna, Italy - marco.dieusanio2@unibo.it.
authors.forename: M
authors.initials: M
authors.lastname: Di Eusanio
authors.forename: F
authors.initials: F
authors.lastname: Dimitri Petridis
authors.forename: G
authors.initials: G
authors.lastname: Folesani
authors.forename: P
authors.initials: P
authors.lastname: Berretta
authors.forename: D
authors.initials: D
authors.lastname: Zardin
authors.forename: R
authors.initials: R
authors.lastname: Di Bartolomeo
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000503:physiopathology / Q000601:surgery*; D001018:Aortic Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001366:Axillary Artery / Q000503:physiopathology; D016122:Brachiocephalic Trunk / Q000503:physiopathology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015897:Comorbidity; D017558:Elective Surgical Procedures; D005260:Female; D006439:Hemodynamics; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012307:Risk Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality