Brain protection with the use of antegrade selective cerebral perfusion and aortic surgery

Selective cerebral perfusion (SCP) has been employed since 1979. High mortality and cerebral complication rates were encountered during the initial period, but with modification of the perfusion condition, the development of a monitoring system, and more experience, these rates were markedly reduced. SCP is most frequently applied for surgery on aortic arch aneurysms, and a standard surgical approach to this lesion has been firmly established since 1986. Recently a more aggressive approach, the "extended application of SCP," was introduced for the purpose of minimizing cerebral complications caused by intraoperative atheromatous embolization. With induction of this new technique in accordance with the present surgical procedure, the cerebral complication rate is now further reduced to the point of being acceptable.