Abstract
Selective cerebral perfusion (SCP), , used for brain protection in aortic arch aneurysm surgery, has been improved by the introduction of the cannulation technique. From 1991 to 1994, arterial cannulas were inserted into the bilateral axillary arteries and the left common carotid artery through each stab wound (Group A, n=12). From 1995, arterial cannulas were inserted through the ostia of the three arch vessels after incision of the aneurysm (Group D, n=27). Cerebral perfusion flow, pressures and cerebral complications were examined in these two groups. The total cerebral perfusion flow in group D was significantly higher than that in group A. The cerebral perfusion pressure in the left common carotid artery in group D was significantly lower than that in the left temporal artery in group A. Permanent brain damage occurred in one patient of group A (8.3%), and in three patients of group D (11.1%). Temporary brain damage was diagnoesd in one patient of group A (8.3%), and in three of group D (11.1%). In conclusion, in group D, anesthetic induction time became shorter and the procedure of SCP could be simplified. No significant differences were observed in incidence of cerebral complications between the two groups.
