[Support techniques in the surgical treatment of aneurysms of the aortic arch]

During the last 15 years, we operated 25 patients of aneurysm of the aortic arch. From 1977 to 1990, various support techniques combined with extracorporeal circulation and carotid bypass were used but from 1990 extracorporeal circulation with selective cerebral perfusion was employed, and so postoperative brain damage was decreased from 47% to 10% (p = 0.05) and operative mortality from 53% to 10% (p = 0.03). We now consider that extracorporeal circulation with selective cerebral perfusion is the best method for cerebral protection in the operation of aneurysms of the aortic arch.