Ma Jiawang, Wang Hong, Wang Xiaomeng, Hou Xiaotong
Center for Cardiac Intensive Care, Beijing Anzhen Hospital, Capital Medical University, 100054 Beijing, China.
Rev Cardiovasc Med. 2024 May 6;25(5):156. doi: 10.31083/j.rcm2505156. eCollection 2024 May.
There has been an increased interest in using antegrade cannulation techniques during surgery for type A aortic dissection. While the utilization of central artery cannulation has been on the rise in recent times, its effectiveness and safety still require thorough examination. This study aimed to explore both the efficiency and safety of central arterial cannulation.
A meta-analysis was conducted on studies that evaluated surgical outcomes when using central artery cannulation (CAC) in comparison to axillary artery cannulation (AXC) or femoral artery cannulation (FAC).
10 retrospective observational studies were included, enrolling 3022 patients (CAC = 1208 vs. FAC = 606; CAC = 1051 vs. AXC = 1119). Among these, 4 articles involved axillary artery cannulation, femoral artery cannulation, and central artery cannulation. Central cannulation was linked to decreased short-term mortality [odds ratio, 0.66, 95% confidence interval (CI) (0.48, 0.89), = 3.27, = 0.007; = 0; = 0.86] compared to femoral cannulation. Additionally, central cannulation was associated with a lower occurrence of temporary neurological dysfunction (TND) [odds ratio, 0.57, 95% CI (0.38, 0.85), = 0.88, = 0.006; = 0%, = 0.83] when compared with femoral cannulation. However, there was no statistical significance in mortality and TND between the central cannulation and axillary cannulation groups.
This meta-analysis reveals that central cannulation surpasses femoral cannulation in lowering short-term mortality and the occurrence of TND among patients undergoing surgery for type A acute aortic dissection. However, central cannulation does not exhibit a higher mortality and TND compared to axillary cannulation.
在A型主动脉夹层手术中，顺行插管技术的应用越来越受到关注。尽管近年来中心动脉插管的使用有所增加，但其有效性和安全性仍需深入研究。本研究旨在探讨中心动脉插管的效率和安全性。
对评估中心动脉插管（CAC）与腋动脉插管（AXC）或股动脉插管（FAC）相比的手术结果的研究进行荟萃分析。
纳入10项回顾性观察性研究，共3022例患者（CAC = 1208例 vs. FAC = 606例；CAC = 1051例 vs. AXC = 1119例）。其中，4篇文章涉及腋动脉插管、股动脉插管和中心动脉插管。与股动脉插管相比，中心插管与短期死亡率降低相关[比值比，0.66，95%置信区间（CI）（0.48，0.89），χ² = 3.27，P = 0.007；I² = 0；P = 0.86]。此外，与股动脉插管相比，中心插管与暂时性神经功能障碍（TND）发生率较低相关[比值比，0.57，95%CI（0.38，0.85），χ² = 0.88，P = 0.006；I² = 0%，P = 0.83]。然而，中心插管组与腋动脉插管组之间的死亡率和TND无统计学意义。
这项荟萃分析表明，在接受A型急性主动脉夹层手术的患者中，中心插管在降低短期死亡率和TND发生率方面优于股动脉插管。然而，与腋动脉插管相比，中心插管并未显示出更高的死亡率和TND。
