{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T12:38:26Z","timestamp":1793795906900,"version":"4.6.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T00:00:00Z","timestamp":1612656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>To prevent embolic stroke during thoracic endovascular aortic repair, we have adopted the brain isolation technique since June 2014 in 9 selected high-risk patients (9\/134: 6.7%) having ulcerated or protruding atheromas within the proximal aorta. Cardiopulmonary bypass was used to prevent aortic atheromas from entering the brain. We used a heparin-coated closed-loop cardiopulmonary bypass system incorporating a soft reservoir bag with 1\u2009mg\/kg heparin to minimize the disadvantages of extracorporeal circulation. The bypass graft (right axillary-left carotid-left axillary) was used as an arterial inflow in patients undergoing zone-1 landing (n\u2009=\u20098), while peripheral cannulation into 3 brachiocephalic arteries was employed in the remaining patient. Initial pump flow was set at 1.3\u2009l\/min\/m2, and native cardiac output was reduced by adjusting the reservoir bag volume. Aortography was performed to confirm non-visualization of the arch vessels before catheter manipulation. There was no mortality and 1 solitary left cerebellar infarction.<\/jats:p>","DOI":"10.1093\/ejcts\/ezab030","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T22:49:27Z","timestamp":1610664567000},"page":"420-422","source":"Crossref","is-referenced-by-count":6,"title":["Functional brain isolation technique for stroke prevention in thoracic endovascular aortic repair"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8033-0039","authenticated-orcid":false,"given":"Kazumasa","family":"Tsuda","sequence":"first","affiliation":[{"name":"First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3301-675X","authenticated-orcid":false,"given":"Naoki","family":"Washiyama","sequence":"additional","affiliation":[{"name":"First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Takahashi","sequence":"additional","affiliation":[{"name":"First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-716X","authenticated-orcid":false,"given":"Norihiko","family":"Shiiya","sequence":"additional","affiliation":[{"name":"First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,7]]},"reference":[{"key":"2021080208043457000_ezab030-B1","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1016\/S0003-4975(01)02922-8","article-title":"Isolation technique for stroke prevention in patients with a mobile atheroma","volume":"72","author":"Shiiya","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"2021080208043457000_ezab030-B2","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s11748-012-0166-4","article-title":"Aortic arch replacement for degenerative aneurysms: advances during the last decade","volume":"61","author":"Shiiya","year":"2013","journal-title":"Gen Thorac Cardiovasc Surg"},{"key":"2021080208043457000_ezab030-B3","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.athoracsur.2019.01.004","article-title":"Neurologic deficit after aortic arch replacement: the influence of the aortic atherosclerosis","volume":"108","author":"Tokuda","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"2021080208043457000_ezab030-B4","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s10047-005-0282-3","article-title":"Use of a soft reservoir bag in a fully heparin-coated closed-loop cardiopulmonary bypass system for distal aortic perfusion during aortic surgery","volume":"8","author":"Shiiya","year":"2005","journal-title":"J Artif Organs"},{"key":"2021080208043457000_ezab030-B5","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1007\/s10047-006-0349-9","article-title":"Heparin reduction with the use of cardiotomy suction is associated with hyperfibrinolysis during distal aortic perfusion with a heparin-coated semi-closed cardiopulmonary bypass system","volume":"9","author":"Shiiya","year":"2006","journal-title":"J Artif Organs"},{"key":"2021080208043457000_ezab030-B6","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1093\/icvts\/ivz310","article-title":"Adjuncts to prevent embolic complications during thoracic endovascular aortic repair for severe atherosclerosis","volume":"30","author":"Tsuda","year":"2020","journal-title":"Interact CardioVasc Thorac Surg"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/60\/2\/420\/39502548\/ezab030.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ejcts\/article-pdf\/60\/2\/420\/39502548\/ezab030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,2]],"date-time":"2021-08-02T08:10:21Z","timestamp":1627891821000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/60\/2\/420\/6130058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,7]]},"references-count":6,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,7]]},"published-print":{"date-parts":[[2021,7,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezab030","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,8,1]]},"published":{"date-parts":[[2021,2,7]]}}}