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The primary endpoints were clinical neurological injury, embolic lesions, and watershed lesions. Multivariable logistic regression was performed to identify independent predictors of the primary outcomes. Survival analysis was performed using Kaplan-Meier estimates.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Clinical neurological injury and embolic lesions were less frequent in patients with retrograde cerebral perfusion (20.2% vs. 28.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.041 and 13.7% vs. 23.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.010, respectively), but there was no significant difference in the occurrence of watershed lesions (3.0% vs. 6.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.156). However, after multivariable logistic regression, retrograde cerebral perfusion was associated with a significant reduction of clinical neurological injury (OR: 0.60; 95% CI 0.36\u20130.995, <jats:italic>p<\/jats:italic>\u2009=\u20090.049), embolic lesions (OR: 0.55; 95% CI 0.31\u20130.97, <jats:italic>p<\/jats:italic>\u2009=\u20090.041), and watershed lesions (OR: 0.25; 95%CI 0.07\u20130.80, <jats:italic>p<\/jats:italic>\u2009=\u20090.027). There was no significant difference in 30-day mortality (12.8% vs. 11.7%, <jats:italic>p\u2009=<\/jats:italic>\u2009ns) or long-term survival between groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In this study, we showed that the addition of retrograde cerebral perfusion during hypothermic circulatory arrest in the setting of acute type A aortic dissection repair reduced the risk of clinical neurological injury, embolic lesions, and watershed lesions.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-024-02814-8","type":"journal-article","created":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T08:02:10Z","timestamp":1716969730000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Retrograde cerebral perfusion reduces embolic and watershed lesions after acute type a aortic dissection repair with deep hypothermic circulatory arrest"],"prefix":"10.1186","volume":"19","author":[{"given":"Jacob","family":"Ede","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Teurneau-Hermansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgitta","family":"Ramgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Moseby-Knappe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Oudin","family":"\u00c5str\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e5rten","family":"Larsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Sj\u00f6gren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Wierup","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahab","family":"Nozohoor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Zindovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"issue":"6","key":"2814_CR1","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1093\/ejcts\/ezw235","volume":"50","author":"IH Melvinsdottir","year":"2016","unstructured":"Melvinsdottir IH, Lund SH, Agnarsson BA, Sigvaldason K, Gudbjartsson T, Geirsson A. 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