Aortic arch surgery is complex, and performing aortic arch coarctation aneurysm resection requires blocking the innominate artery, left carotid artery, and left subclavian artery, which requires cerebral protection. Since cerebral protection is a comprehensive technical measure, there are various surgical options at present. 1.Artificial vessel bypass: Instead of using extracorporeal circulation, the procedure is performed by a temporary rerouting technique, either through an artificial vessel bypass or through a cannula for external bypass plus a transfusion device. This procedure is only possible when the ascending aorta is normal, and the bypass tube must be removed after the vascularization of the arch is completed, requiring a longer operation time and more bleeding. 2.Extracorporeal circulation with cerebral arterial perfusion method: Extracorporeal circulation with cerebral arterial perfusion method is suitable for aortic arch aneurysm that has not yet invaded to the right subclavian artery. The right subclavian artery and femoral artery are cannulated and the superior and inferior vena cava are cannulated to establish extracorporeal circulation, and the cerebral arteries and coronary arteries are perfused at the same time. Exposure of the aortic arch, located deeper in the thoracic cavity, is more difficult, and separation must reach the aorta and the three cephalobrachial arterial trunks downstream of control. Only partial resection of their aortic aneurysm is performed. The artificial vessels are well clipped to avoid distortion after transplantation, and the cephalic-arm trunks are transplanted mostly into whole pieces into the artificial vessels. The problem with this approach is the perfusion of the brain, where one controls the pressure of cerebral perfusion relatively easily, while the control of cerebral blood flow is not very certain, and despite the intraoperative concomitant use of cryoprotection, intraoperative EEG changes and postoperative neurological sequelae are not uncommon. The difficulty is that the cerebral perfusion must reach 75 ml/s, below which the brain is ischemic, but the perfusion pressure cannot be higher than 100 mmHg, otherwise cerebral edema may occur. 3. Retrograde perfusion method: This method was proposed by HouYuLin and is suitable for cases in which the aneurysm has invaded the subclavian artery. The lesion is revealed using a median sternotomy and a left thoracic incision through the 5th intercostal space. The left subclavian artery, the left common carotid artery, and the unnamed artery were then anastomosed to the artificial vessel, and retrograde perfusion was performed through the artificial vessel. The descending aorta is severed 2 cm distal to the aortic aneurysm, close above the anastomosis of the artificial vessel, and the aortic aneurysm is removed, and the proximal end of the artificial vessel is anastomosed end-to-end or end-to-side with the ascending aorta. The advantage of this procedure is that it avoids cannulation of the cerebral vessels and shortens the time of aortic block. The disadvantage is that the surgical operation takes longer and the head and arm trunk vessels are sometimes prone to distortion after the anastomosis. 4.Deep hypothermic stop circulation method: This method was proposed by Dubost in 1959 and was first used clinically. The ascending aorta and femoral artery were used to insert perfusion tubes and upper and lower vena cava drains for extracorporeal circulation, slowly cooled to a nasal temperature of 15~17℃, stopped circulation, clamped the three branches of the aortic arch to prevent air embolism, incised the aortic aneurysm, anastomosed the distal end of the artificial vessel with the descending aorta on the inner surface of the aorta, and later transplanted the three branches of the aortic arch in the form of pieces to the The proximal end of the artificial vessel is then clamped, and after venting, the extracorporeal circulation is restored, and the clamp of the three branches is opened, and finally the proximal end of the artificial vessel is anastomosed to the ascending aorta. It is gradually warmed to normal temperature. The advantages of this method are that the operation is easily performed under stopped circulation, the operation is simplified, and the operation time is relatively shortened. 5.Superior vena cava retrograde perfusion to deepen the low temperature stop circulation: In 1980, Mills first reported the successful prevention and treatment of cerebral pneumothorax with superior vena cava retrograde perfusion method. 1990, Ueda et al. in Japan reported 6 cases of intermittent and 2 cases of continuous retrograde perfusion of cerebral protection for ascending aorta and arch aneurysm surgery to obtain satisfactory clinical results, the longest case of one stop circulation and intermittent retrograde perfusion for 102 minutes. In 1992, Yasuura et al. reported the longest case of 110 minutes of continuous retrograde perfusion cerebral protection for aortic arch surgery, with no neurological complications after surgery. 6, right subclavian artery cannulation retrograde perfusion deepening cryopause circulation selective cerebral protection method: The right subclavian artery and femoral artery were used for extracorporeal circulation with simultaneous cannulation of perfusion tube. During the distal anastomosis of the artificial vessel and the descending aorta, the right subclavian artery is selectively perfused from the brain. After completion of the distal anastomosis, the artificial vessel was blocked from simultaneous perfusion from the femoral artery and the right subclavian artery, and the arch and proximal vessel replacement was continued.