Оцінка ефективності й безпечності використання аксилярної канюляції при хірургічному лікуванні патології грудної аорти

Vollständiger Abstract

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The aim – to evaluate the efficacy and safety of direct axillary artery cannulation during reconstructive surgery for thoracic aortic disease by comparing intraoperative parameters, early clinical outcomes, and the incidence of neurological and local complications with those of femoral artery cannulation.Materials and methods. The study included 110 patients who underwent reconstructive surgery for thoracic aortic disease between 2016 and 2025 using peripheral arterial cannulation. Femoral artery cannulation was performed in 62 patients, while direct axillary artery cannulation was used in 48 patients. The study groups were comparable with respect to baseline demographic and clinical characteristics.Results. Axillary artery cannulation was associated with a significantly shorter duration of circulatory arrest (6.2 ± 2.3 vs. 14.6 ± 3.7 min; p < 0.001), intensive care unit stay (2.3 ± 0.5 vs. 3.4 ± 0.8 days; p < 0.001), and overall hospital stay (9.4 ± 4.3 vs. 16.6 ± 6.1 days; p < 0.001). The incidence of transient neurological deficit was significantly lower in the axillary cannulation group (4.2 % vs. 16.1 %; p = 0.045), whereas no statistically significant differences were observed in operative mortality or postoperative stroke. Direct axillary artery cannulation demonstrated a high technical success rate and a low incidence of local vascular complications.Conclusions. The findings of this study demonstrate that direct axillary artery cannulation is a safe, effective, and reproducible technique for arterial inflow during reconstructive surgery of the thoracic aorta. This approach provides adequate systemic and cerebral perfusion, is associated with a low rate of local complications, and yields favorable early clinical outcomes.