Postoperative renal function preservation with nonischemic femoral arterial cannulation for thoracoabdominal aortic repair Charles C. Miller, PhD, Joshua.

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Presentation transcript:

Postoperative renal function preservation with nonischemic femoral arterial cannulation for thoracoabdominal aortic repair Charles C. Miller, PhD, Joshua C. Grimm, BS, Anthony L. Estrera, MD, Ali Azizzadeh, MD, Sheila M. Coogan, MD, Jon-Cecil M. Walkes, MD, Hazim J. Safi, MD Journal of Vascular Surgery Volume 51, Issue 1, Pages 38-42 (January 2010) DOI: 10.1016/j.jvs.2009.08.044 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 In the standard cannulation technique, the femoral artery is cannulated, and the cannula is secured with a tourniquet, occluding the artery for distal antegrade flow below the tourniquet. Journal of Vascular Surgery 2010 51, 38-42DOI: (10.1016/j.jvs.2009.08.044) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 In the nonocclusive sidearm technique, the sidearm graft allows blood flow to pressurize the artery both proximal (retrograde flow) and distal (antegrade flow) to the sidearm cannulation site (Bio-Medicus; Medtronic, Minneapolis, Minn). Journal of Vascular Surgery 2010 51, 38-42DOI: (10.1016/j.jvs.2009.08.044) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Peak postoperative creatinine relationship to preoperative glomerular filtration rate (GFR) is shown by cannulation technique. When GFR is low, the sidearm technique reduces peak creatinine levels and flattens the relationship between the preoperative GFR and the postoperative creatinine value. Journal of Vascular Surgery 2010 51, 38-42DOI: (10.1016/j.jvs.2009.08.044) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 4 Probability of postoperative renal dysfunction as it relates to preoperative glomerular filtration rate (GFR) by cannulation technique is shown. Sidearm cannulation reduces the effect of preoperative GFR on postoperative renal dysfunction at low GFR values. Journal of Vascular Surgery 2010 51, 38-42DOI: (10.1016/j.jvs.2009.08.044) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 5 Mortality related to preoperative glomerular filtration rate (GFR) by sidearm and direct cannulation shows a similar pattern to renal variables. Results were not statistically significant at the current sample size. Journal of Vascular Surgery 2010 51, 38-42DOI: (10.1016/j.jvs.2009.08.044) Copyright © 2010 Society for Vascular Surgery Terms and Conditions