scholarly journals Modified Isolated Cerebral Perfusion Technique for Prevention of Stroke With Aortic Arch Replacement

2021 ◽  
Author(s):  
Yasumi Maze ◽  
Toshiya Tokui ◽  
Masahiko Murakami ◽  
Teruhisa Kawaguchi ◽  
Ryosai Inoue ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Subclavian Artery ◽  
Cerebral Perfusion ◽  
Left Subclavian Artery ◽  
Axillary Artery ◽  
Selective Cerebral Perfusion ◽  
Aortic Arch Replacement ◽  
Artery Cannulation ◽  
Postoperative Stroke ◽  
Artificial Graft

Abstract In aortic arch replacement, an isolated cerebral perfusion method has been reported in additional to axillary artery cannulation to prevent postoperative stroke. We have made changes to this method. In other words, we devised a method to reduce cerebral embolism by performing selective cerebral perfusion via an artificial graft anastomosed to the left common carotid artery and the left subclavian artery. This method was performed in 7 cases, and all patients were discharged alive without any neurological disorders. In the surgical procedure of the aortic arch, sufficient care must be taken in the manipulation around the brachiocephalic artery and the left subclavian artery. Our method can avoid reinsertion due to desorption of the cerebral perfusion cannula and can be expected to prevent postoperative stroke.

Axillary artery cannulation: routine use in ascending aorta and aortic arch replacement

2004 ◽  
Vol 78 (1) ◽  
pp. 103-108 ◽  
Author(s):  
Justus T Strauch ◽  
David Spielvogel ◽  
Alexander Lauten ◽  
Steven L Lansman ◽  
Kirk McMurtry ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Axillary Artery ◽  
Ascending Aorta ◽  
Aortic Arch Replacement ◽  
Artery Cannulation

Aortic Arch Replacement Using Selective Cerebral Perfusion

2007 ◽  
Vol 83 (2) ◽  
pp. S796-S798 ◽  
Author(s):  
Teruhisa Kazui ◽  
Katsushi Yamashita ◽  
Naoki Washiyama ◽  
Hitoshi Terada ◽  
Abul Hasan Muhammad Bashar ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Selective Cerebral Perfusion ◽  
Aortic Arch Replacement

An Assessment of Selective Cerebral Perfusion Via the Innominate Artery in Aortic Arch Replacement

1998 ◽  
Vol 46 (01) ◽  
pp. 7-11 ◽  
Author(s):  
G. Wozniak ◽  
F. Dapper ◽  
E. Schindler ◽  
H. Akintürk ◽  
B. Zickmann ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Cerebral Perfusion ◽  
Innominate Artery ◽  
Selective Cerebral Perfusion ◽  
Aortic Arch Replacement

scholarly journals The arteries originating from the aortic arch and the branches of these arteries in red squirrels (Sciurus vulgaris)

2011 ◽  
Vol 56 (No. 3) ◽  
pp. 131-134 ◽  
Author(s):  
A. Aydin
Keyword(s):  
Carotid Artery ◽  
Aortic Arch ◽  
Subclavian Artery ◽  
Common Carotid Artery ◽  
Left Subclavian Artery ◽  
Axillary Artery ◽  
Thoracic Cavity ◽  
Sciurus Vulgaris ◽  
Brachiocephalic Trunk ◽  
The Right

This study had the aim of investigating the anatomy of the aortic arch in squirrels (Sciurus vulgaris). Ten squirrels were studied. The materials were carefully dissected and the arterial patterns of arteries originating from the aortic arch were examined. The brachiocephalic trunk and the left subclavian artery were detached from the aortic arch. The brachiocephalic trunk first gave the left common carotid artery, and then detached to the right subclavian and common carotid artery. In all the examined materials, the left and right subclavian arteries gave branches that were similar after leaving the thoracic cavity from the cranial thoracic entrance. But while the whole branches of the the right subclavian artery were arising from almost the same point the left subclavian artery gave these branches in a definite order, and the branches that separated were the following: the internal thoracic artery, the intercostal suprema artery, the ramus spinalis, the vertebral artery and the descending scapular artery. It also gave the common branch formed by the junction of three of the cervical superficial, the cevical profund and the suprascapular arteries. After the separation of these branches, continuation of the artery gave the external thoracic artery on the external face of the thoracic cavity and then formed the axillar artery. The axillary artery separated into the subscapular and the brachial arteries. Thus, the arteries originating from the aortic arch and the branches of these arteries are different from other rodents and from domestic mammals.

Use of On-Site Digital Subtraction Angiography for Left Subclavian Artery Management During Hybrid Aortic Arch Repair in DeBakey I Dissection

2022 ◽  
pp. 152660282110687
Author(s):  
Peter-Lukas Haldenwang ◽  
Mahmoud Elghannam ◽  
Dirk Buchwald ◽  
Justus Strauch
Keyword(s):  
Digital Subtraction Angiography ◽  
Subclavian Artery ◽  
Cerebral Perfusion ◽  
Left Subclavian Artery ◽  
Circulatory Arrest ◽  
False Lumen ◽  
Distal Anastomosis ◽  
Digital Subtraction ◽  
Selective Cerebral Perfusion ◽  
Elephant Trunk

Purpose: A hybrid aortic repair using the frozen elephant trunk (FET) technique with an open distal anastomosis in zone 2 and debranching of the left subclavian artery (LSA) has been demonstrated to be favorable and safe. Although a transposition of the LSA reduces the risk of cerebellar or medullar ischemia, this may be challenging in difficult LSA anatomies. Case Report: We present the case of a 61-year old patient with DeBakey I aortic dissection, treated with FET in moderate hypothermic circulatory arrest (26°C) and selective cerebral perfusion using a Thoraflex-Hybrid (Vascutek Terumo) prosthesis anchored in zone 2, with overstenting of the LSA orifice and no additional LSA debranching. Sufficient perfusion of the LSA was proved intraoperatively using LSA backflow analysis during selective cerebral perfusion in combination with on-site digital subtraction angiography (ARTIS Pheno syngo software). No neurologic dysfunction or ischemia occurred in the postoperative course. An angiographic computed tomography revealed physiologic LSA perfusion, with subsequent thrombotic occlusion of the false lumen in the proximal descending aorta after 7 days. Conclusion: Using an angiography-guided management in patients with complex DeBakey I dissection and difficult anatomy may simplify a proximalization of the distal anastomosis in zone 2 for FET, even without an additional LSA debranching.

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