Evidence map›Paper›PMID 28601820›Full record

Trial reportBMJ open2017

Axillary versus innominate artery cannulation for antegrade cerebral perfusion in aortic surgery: design of the Aortic Surgery Cerebral Protection Evaluation (ACE) CardioLink-3 randomised trial.

Vinay Garg, Mark D Peterson, Michael Wa Chu, Maral Ouzounian, Roderick Gg MacArthur, John Bozinovski, Ismail El-Hamamsy, F Victor Chu, Ankit Garg, Judith Hall and 10 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02554032 (A Randomized Controlled Trial of Axillary vs. Innominate Artery Cannulation for Antegrade Cerebral Protection in Aortic Surgery), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02554032 nacompletednot on this map

A Randomized Controlled Trial of Axillary vs. Innominate Artery Cannulation for Antegrade Cerebral Protection in Aortic Surgery: The ACE Randomized Trial

TypeinterventionalSponsorUnity Health TorontoRan2015 to 2018Enrolled110ConditionsAortic Aneurysm, ThoracicArmsAxillary artery cannulation, Innominate artery cannulation
3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Neuroprotective Strategies in Repair and Replacement of the Aortic Arch.The International journal of angiology : official publication of the International College of Angiology, Inc · 2018
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Vinay GargDepartment of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
Mark D PetersonDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Michael Wa ChuDivision of Cardiac Surgery, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada.
Maral OuzounianDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada.
Roderick Gg MacArthurDivision of Cardiac Surgery, University of Alberta Hospital, University of Alberta, Edmonton, Alberta, Canada.
John BozinovskiDivision of Cardiac Surgery, Royal Jubilee Hospital, University of British Columbia, Victoria, British Columbia, Canada.
Ismail El-HamamsyDivision of Cardiac Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada.
F Victor ChuDivision of Cardiac Surgery, Department of Surgery, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada.
Ankit GargDepartment of Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
Judith HallApplied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Kevin E ThorpeApplied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Natasha DhingraDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Hwee TeohDivision of Cardiac Surgery, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Thomas R MarottaDepartment of Diagnostic and Therapeutic Neuroradiology, Keenan Research Centre for Biomedical Science of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
David A LatterDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Adrian QuanDivision of Cardiac Surgery, Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Muhammad MamdaniDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Peter JuniApplied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
C David MazerDepartment of Anesthesia, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Subodh VermaDepartment of Surgery, University of Toronto, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionNeurological injury remains the major cause of morbidity and mortality following open aortic arch repair. Systemic hypothermia along with antegrade cerebral perfusion (ACP) is the accepted cerebral protection approach, with axillary artery cannulation being the most common technique used to establish ACP. More recently, innominate artery cannulation has been shown to be a safe and efficacious method for establishing ACP. Inasmuch as there is a lack of high-quality data comparing axillary and innominate artery ACP, we have designed a randomised, multi-centre clinical trial to compare both cerebral perfusion strategies with regards to brain morphological injury using diffusion-weighted MRI (DW-MRI). METHODS AND ANALYSIS: 110 patients undergoing elective aortic surgery with repair of the proximal arch requiring an open distal anastamosis will be randomised to either the innominate artery or the axillary artery cannulation strategy for establishing unilateral ACP during systemic circulatory arrest with moderate levels of hypothermia. The primary safety endpoint of this trial is the proportion of patients with new radiologically significant ischaemic lesions found on postoperative DW-MRI compared with preoperative DW-MRI. The primary efficacy endpoint of this trial is the difference in total operative time between the innominate artery and the axillary artery cannulation group. ETHICS AND DISSEMINATION: The study protocol and consent forms have been approved by the participating local research ethics boards. Publication of the study results is anticipated in 2018 or 2019. If this study shows that the innominate artery cannulation technique is non-inferior to the axillary artery cannulation technique with regards to brain morphological injury, it will establish the innominate artery cannulation technique as a safe and potentially more efficient method of antegrade cerebral perfusion in aortic surgery. TRIAL REGISTRATION NUMBER: NCT02554032.

Indexed as

Cerebrovascular CirculationAgedAorta, ThoracicAxillary ArteryBrachiocephalic TrunkBrain IschemiaCatheterization, PeripheralCirculatory Arrest, Deep Hypothermia InducedDiffusion Magnetic Resonance ImagingFemaleHospital MortalityHumansMaleMiddle AgedOperative TimePerfusionantegrade cerebral perfusionaxillary arteryminate arterymoderate hypothermiarandomised trial

Identifiers

PMID28601820
PMCPMC5623414

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.