BackgroundTo evaluate the efficacy of isolated cerebral perfusion (ICP) for the prevention of cerebral infarction and the occurrence of early mortality, we retrospectively compared the outcomes between old patients with or without ICP in total arch replacement (TAR)MethodsBetween January 2003 and March 2019, 74 patients aged older than 75 years underwent elective TAR for arch aneurysm. The participants were divided into two groups according to the brain protection method used: the ICP method

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... P group, n = 46) and the selective antegrade cerebral perfusion method (non-ICP group, n = 28). ResultsThe 30-day mortality rates of both groups were zero. The in-hospital mortality rates of the ICP and non-ICP groups were 4.3% and 3.5%, respectively. The median follow-up duration was 34 months, and the 1-year survival rates were 90.1% in the ICP group and 90.7% in the non-ICP group. The incidence of postoperative cerebral infarction was significantly lower in the ICP group (n = 1, 2.1%) than in the non-ICP group (n = 5, 17.8%).ConclusionsICP could result in a lower incidence of postoperative cerebral infarction in old patients who undergo TAR.