A Contemporary Meta-Analysis of Antegrade versus Retrograde Cerebral Perfusion for Thoracic Aortic Surgery.

 To determine which of antegrade and retrograde cerebral perfusion (ACP and RCP) surpasses for a reduction in postoperative incidence of neurological dysfunction and all-cause death in thoracic aortic surgery, we performed a meta-analysis of contemporary comparative studies.  MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched from January 2010 to June 2017. For each study, data regarding the endpoints in both the ACP and RCP groups were used to generate odds ratios (ORs) and 95% confidence intervals (CIs). Study-specific estimates were combined using inverse variance-weighted averages of logarithmic ORs in the fixed-effect model.  We identified and included 19 eligible studies with a total of 15,365 patients undergoing thoracic aortic surgery by means of ACP (a total of 7,675 patients) or RCP (a total of 7,690 patients). Pooled analysis demonstrated no statistically significant differences in postoperative incidence of stoke (17 studies enrolling a total of 9,421 patients; OR, 0.92; 95% CI, 0.79-1.08;  In thoracic aortic surgery, postoperative incidence of stroke and mortality was similar between ACP and RCP, whereas a trend toward a reduction of TND incidence existed in ACP.

Georg Thieme Verlag KG Stuttgart · New York.

None declared.