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Updated: Feb 16, 2026

Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Brain protection in aortic arch aneurysm: antegrade or retrograde?
Amer Harky1, Matthew Fok2, Mohamad Bashir3
1Department of Cardiac Surgery, Barts Heart Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.
Abstract:
During open aortic arch repair, there is an interruption of cerebral perfusion and to prevent neurological sequelae, the hypothermic circulatory arrest has been established to provide sufficient brain protection coupled with adjuncts including retrograde and antegrade cerebral perfusion. To date, brain protection during open aortic arch repair is a contested topic as to which provides superior brain protection with little evidence existing to suggest supremacy of one modality over the other. This article reviews current literature reflecting on key and emerging studies in brain protection and their associated outcomes in patients undergoing open aortic arch surgery.
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