“…1,2 Nowadays, cardiac surgeons sometimes encounter patients with extensive atherosclerosis, multiple aortic aneurysms, and/or a severely atheromatous ascending aorta, called "shaggy aorta." 3 In these conditions, manipulation of the ascending aorta, including cannulation and clamping, may cause deleterious atheroembolism and should be avoided. 4,5 Retrograde perfusion from the femoral artery may induce paradoxical atheroembolism to the brain in patients with iliac artery atherosclerosis, an abdominal aortic aneurysm, and/or a descending aortic aneurysm.…”