OBJECTIVES:
 Substantial improvement has been observed in the surgical treatment of Type-A aortic dissections in parallel with the developments in cerebral perfusion techniques. Introduction of antegrade (ACP) and retrograde (RCP) cerebral perfusion techniques with deep hypothermic total circulatory arrest (HTCA) significantly decreased neurological complications which are the most important cause of morbidity and early mortality. The incidence of temporary (TND) or permanent neurological dysfunction (PND) is still between 5.5 – 33.3%. The cerebral perfusion method is effective on this ratio, as well as factors such as age, presence of co-morbidities, emergency, diameter of the aortic arch and the ascending aorta segment that is replaced. 
 METHODS:
 In this study we have compared the operative and clinical outcomes of patients with Stanford Type-A dissection whom we operated by using antegrade and retrograde cerebral perfusion. We have also investigated which perfusion method is superior to the other, the determinants of mortality and complication rates according to the groups in order to find the determinants of mortality, and to evaluate the complication rates. The data of 115 patients who were operated for acute, subacute or chronic Stanford Type A dissection and intramural hematoma (IMH) between January 2001 – March 2013 were retrospectively evaluated.
 RESULTS: 
 No significant differences in CPB, XC, TCA, ACP, total amount of post-operative drainage, requirement of blood products, ventilation time, duration of ICU stay, hospital stay, and early mortality rates were found in our evaluation of findings and outcomes of patients in whom we either used the ACP or the RCP technique. In the multivariate analysis determinants of mortality were preoperative presence of hypertension, diabetes mellitus, extremity malperfusion, duration of CPB, and postoperative renal complications.
 CONCLUSIONS: 
 The results of our study and results of others in the medical literature regarding techniques for brain protection in open ascending and aortic arch surgery have suggested that the most effective approach to decrease the neurological complications and to obtain better outcomes may be to decrease the duration of perfusion to the possible extent.