Increased cerebrovascular resistance after retrograde cerebral perfusion: A Doppler study

Kin, Nobuhide; Ono, Nagara; Mori, Yoichi; Ninagawa, Jun; Yamada, Yosuke

doi:10.5582/bst.2012.v6.5.276

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…The main limitations of this study are its retrospective design and the small sample analyzed. Moreover, it may be considered that the cerebral blood flow during sACP could be affected by many other factors, including the cerebrovascular resistance, the cerebral electrophysiological activity, the haematocrit, the PaCO 2 , the anaesthetics, the catecholamines and the vasodilators 24 . Furthermore, patients may have postoperative cognitive impairment without any evidence of neurological abnormalities 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it may be considered that the cerebral blood flow during sACP could be affected by many other factors, including the cerebrovascular resistance, the cerebral electrophysiological activity, the haematocrit, the PaCO 2 , the anaesthetics, the catecholamines and the vasodilators. 24 Furthermore, patients may have postoperative cognitive impairment without any evidence of neurological abnormalities. 25 This cognitive decline, which especially affects memory, attention and information processing, could be detected by highly sensitive neuropsychological tests that were not used in this study.…”

Section: Discussionmentioning

confidence: 99%

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Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions

Berardi

Marco

Leone

et al. 2022

Journal of Cardiovascular Medicine

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Aims Selective antegrade cerebral perfusion technique is a method of cerebral protection used worldwide during aortic arch surgery. This study was designed to identify a potential correlation between perfusion flows and the development of postoperative transient neurological dysfunctions.Methods From January 2015 to May 2020, 175 patients underwent elective surgical replacement of the aortic arch using selective antegrade cerebral perfusion at the Cardiac Surgery Unit of Sant'Orsola Hospital in Bologna. Considering that patients who developed a permanent neurological dysfunction and those who died before a possible evaluation of neurological status were excluded, the study population included 160 patients. The perfusion flows were collected and analyzed. Univariate and multivariate analyses were performed to identify the statistical risk factors involved in the onset of transient neurological dysfunctions. ResultsThe study population was divided into two groups: 138 patients (86.3%) without and 22 (13.8%) with postoperative transient neurological complications. Among the intra-operative parameters collected in the study, the univariate analysis showed that the indexed medium perfusion flow of selective antegrade cerebral perfusion was significantly lower in the transient neurological dysfunctions group (11.63 W 2.41 ml/kg/min vs 12.62 W 2.39 ml/kg/min, P-value U 0.03). The multivariate logistic regression analysis showed that the female gender (P U 0.004, OR U 4.816, IC U 1.636-14.174) was predictor of transient neurological dysfunctions. ConclusionThe results of the study showed that lower perfusion flows seem to be related to a higher probability of developing transient neurological dysfunctions. However, the analysis of a wider population is required to confirm these preliminary data.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions

Berardi

Marco

Leone

et al. 2022

Journal of Cardiovascular Medicine

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Cerebral Circulation in Patients With Fontan Circulation: Assessment by Carotid Arterial Wave Intensity and Stiffness

Saiki¹,

Kurishima²,

Masutani³

et al. 2014

The Annals of Thoracic Surgery

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Unilateral Antegrade Cerebral Perfusion during Aortic Arch Repair

Kozlov,

Panfilov

2024

Advances in Vascular Surgery [Working Title]

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Circulatory arrest is one of the most crucial timeframes during aortic arch surgery due to the increased ischemic risk for inner organs, including the brain. In this regard, the issue of intraoperative cerebral protection is of great importance. Despite the fact that antegrade cerebral perfusion is the preferred neuroprotective strategy during aortic arch surgery, including the frozen elephant trunk procedure, the choice of the best perfusion technique for cerebral protection is still a matter of debate. We conducted a comprehensive analysis of cerebral status in 97 patients who underwent total arch repair using the frozen elephant trunk technique under moderate hypothermia and unilateral cerebral perfusion via an innominate artery. Our analysis, including intraoperative monitoring of cerebral oximetry, the incidence of postoperative neurological deficit and cognitive impairment, and added assessment of a neuronal injury marker level (neuron-specific enolase), demonstrates the high efficacy and safety of unilateral antegrade cerebral perfusion via an innominate artery.

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Increased cerebrovascular resistance after retrograde cerebral perfusion: A Doppler study

Cited by 3 publications

References 33 publications

Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions

Elective aortic arch surgery: cerebral perfusion flows and transient neurological dysfunctions

Cerebral Circulation in Patients With Fontan Circulation: Assessment by Carotid Arterial Wave Intensity and Stiffness

Unilateral Antegrade Cerebral Perfusion during Aortic Arch Repair

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