Thoracic aortic occlusion: somatosensory evoked potential monitoring and neurologic outcome in a canine model.
Somatosensory evoked potentials (SEPs) were monitored in 17 canines during spinal cord ischemia induced by balloon occlusion of the thoracic aorta. Graded distal aortic hypotension to 40 mmHg in seven animals had no significant effect upon the evoked potential. A significant alteration in the SEP did result in 21 +/- 9.8 minutes when distal aortic pressures were reduced in a graded fashion below 30 mmHg. Acute occlusion of the thoracic aorta (10 animals, distal pressure 15-25 mmHg) was associated with a change in the SEP in 8.4 +/- 4.3 minutes. Continuation of aortic occlusion for 30 minutes beyond an evoked potential change resulted in a moderate to severe motor deficit in all cases. Somatosensory evoked potentials obtained 72-96 hours after the ischemic injury were closely correlated with sensory deficits, but were not predictive of motor examination. Histologic examination of the spinal cords demonstrated central gray necrosis of the lumbar region in all animals with a severe deficit, and a variable degree of neuronal loss in the intermediate and dorsal gray matter zones in animals with moderate deficits. This balloon occlusion method is relevant as a model of spinal cord injury during aortic occlusion, such as may occur during aortic surgery.
Kaplan
B J
BJ
Division of Neurosurgery, University of Texas Medical Branch, Galveston 77550.
Gravenstein
N
N
Friedman
W A
WA
Blackmore
J
J
Curran
M
M
D000208:Acute Disease; D000818:Animals; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000473:pathology / Q000503:physiopathology*; D001157:Arterial Occlusive Diseases / Q000473:pathology / Q000503:physiopathology*; D004285:Dogs; D005073:Evoked Potentials, Somatosensory; D008991:Monitoring, Physiologic; D009420:Nervous System / Q000503:physiopathology*; D013116:Spinal Cord / Q000473:pathology