Evaluation of Willis Polygon variations on aortic surgery patients with unilateral antegrade cerebral perfusion

Abstract

Introduction: To determine the effects of wiilis polygon variations on long-term survival in patients with aortic aneurysm and/or aortic dissection operated with the Antegrade Selective Cerebral Perfusion (ASSP) technique Methods: Twenty patients with ascending, arcus aneurysm and dissection who underwent antegrade selective cerebral perfusion via the right brachial artery were prospectively studied. Willis polygon variations were detected by cerebral multi-section computed tomographic angiography device. Cooling degrees, cross-clamping, low flow, total perfusion times, postoperative intensive care unit stay, neurologic examination, and hospitalization times were evaluated. Results: of the patients, 70% (14) were male and 30% (6) were female, with a mean age of 54.20±10.58 (38-70). Five patients had Stanford type 1 aortic dissection and fifteen patients had ascending and/or aortic aortic aneurysms. The mean cardiopulmonary bypass times of the patients were 146±32.9 (82-200) minutes, the cross-clamp times were 101±31.6 (47-165) minutes, and the selective cerebral perfusion times were 26±7.8 (16-45) minutes. Only one patient had paresthesia and loss of function in the right hand, and almost complete clinical improvement was observed on the second postoperative day. Discussion and Conclusion: With this study, we defined the willis polygon variations in the population. As we have determined; If there are three communicating arteries, the variations are not significant. Unless the patients are in the high-risk group, it is not necessary to evaluate the willis polygon variations before the procedure in patients who will undergo surgery with antegrade cerebral perfusion.