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[Treatment of aneurysm of aortic arch using selective cerebral perfusion].

The objective of this study is to evaluate safety and efficacy of the selective cerebral perfusion (SCP) for an adjunct to perform operation of aortic arch aneurysms. From November 1982 to June 1993, surgical treatment of aneurysm of aortic arch using SCP was performed in 22 patients. The hospital death was accounted in 5 cases (23%), the intraoperative stroke was observed in 3 cases (14%) and these patients died. The cause of intraoperative stroke was cerebral hypoperfusion due to multiple sclerosis of intracranial arteries or insufficient SCP. Variables of an increased operative risk seemed to be older age (over 70 y.o.) and rupture. SCP time more than 120 minutes did not promote the operative risk. Cerebral hypoperfusion was directly responsible for not only intraoperative stroke, but also operative death. Therefore, SCP seems effective and safe if hypoperfusion is prevented.