In Thoracic Aortic Surgery, Is Innominate Artery Cannulation a Safe and Effective Alternative to Axillary Artery Cannulation?
In this best evidence topic paper, the authors examined outcome and safety of innominate artery cannulation versus axillary artery cannulation in thoracic aortic surgery. There were no significant differences in mortality with innominate artery cannulation compared to axillary artery cannulation. In most studies, a stroke occurred slightly less frequently in patients receiving innominate artery cannulation compared to axillary artery cannulation. The authors conclude that innominate artery cannulation is noninferior to axillary artery cannulation.
Nice piece of work. They don’t mention another, to my mind, significant advantage of innominate cannulation in that heparinisation is delayed until the chest is open and initial haemostats secured. This is of particular advantage in the setting of emergency surgery, such as for aortic dissection, where there is already a coagulopathy