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NCT Number: NCT06870513

Comparative Study of Antegrade Versus Retrograde Cerebral Perfusion in Acute Type A Aortic Dissection: A Prospective Study

This prospective study investigated the comparison of effectiveness of antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP) in providing cerebral protection during the surgical treatment of acute Type A aortic dissection (TAAD). Acute type A aortic dissection presents an aortic tear at its ascending portion, posing considerable risk with high morbidity and mortality incidence, especially from neurological insults.

In total, 116 patients with acute type A aortic dissection were randomly assigned to undergo surgical intervention with either ACP through axillary artery cannulation or RCP through superior vena cava cannula placed during deep hypothermic circulatory arrest. Primary objectives focused on measuring and comparing the postoperative neurological complication rates associated with transient neurological deficits (TND) and permanent neurological deficits (PND). Secondary outcomes of interest included the duration of mechanical ventilation, length of stay in the ICU and hospital, and mortality.

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Key information

Conditions

Acute Type A Aortic Dissection

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Department of Cardiothoracic Surgery, Faculty of Medicine, Suez Canal University.

Suez Canal, Ismailia Governorate, 41522, Egypt

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients diagnosed with acute type A aortic dissection (TAAD).

Exclusion criteria

  • Hemodynamic instability.
  • Known ischemic heart disease (IHD).
  • History of cerebrovascular stroke.
  • Heart failure.
  • Renal or hepatic impairment.
  • Rheumatic heart disease.
  • Previous history of radiotherapy.

Treatment and study plan

Antegrade Cerebral Perfusion via Axillary Artery

Procedure

In antegrade cerebral perfusion (ACP), patients underwent cannulation of the right axillary artery using an interposition Dacron graft (7 mm) connected to a cardiopulmonary bypass (CPB) circuit. During surgery, ACP delivered oxygenated blood flow directly into the brain arteries to maintain cerebral protection during the period of deep hypothermic circulatory arrest (DHCA), enabling the surgical team to perform the distal aortic anastomosis safely.

Other names: Antegrade Brain Perfusion

Retrograde Cerebral Perfusion via Superior Vena Cava

Procedure

In retrograde cerebral perfusion (RCP), cannulation of the superior vena cava (SVC) was performed to deliver blood flow in reverse direction during deep hypothermic circulatory arrest (DHCA). This method aimed to provide cerebral protection by supporting cerebral metabolism during the surgical repair of acute Type A aortic dissection.

Other names: Retrograde Brain Perfusion

Primary outcomes

  1. Incidence of Neurological Complications (Transient and Permanent Neurological Deficits)

    Time frame: Postoperative assessment period (up to 30 days after surgery)

    Comparison of the incidence of neurological complications, including transient neurological deficits (temporary postoperative mental status changes or neurological dysfunction resolving within 24 hours) and permanent neurological deficits (lasting neurological impairments such as stroke, paralysis, coma, or death).

Secondary outcomes

  1. Postoperative Mortality Rate

    Time frame: 30 days post-surgery

    Comparison of mortality rates within 30 days following surgical intervention between the two perfusion groups (ACP vs. RCP).

Sponsors and collaborators

Lead sponsor

Yusuf Shieba

Other

Registry information

Official study title

Comparative Study Between Antegrade and Retrograde Cerebral Perfusion in Acute or Subacute Aortic Dissection Type (A) Patients

Important dates

Study start
2020
Primary completion
2023
Study completion
2023
First posted
Mar 11, 2025
Registry last updated
May 30, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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