Thoracoabdominal aortic aneurysm. How we do it.
A systematic approach to paraplegia risk in the surgical treatment of thoracoabdominal aortic aneurysms based on effective strategies identified from the experimental literature is discussed. With this approach, collateral blood flow, rather than direct intercostal reimplantation, moderate hypothermia and endorphin receptor, is emphasized blockade. The result has been a 10-fold reduction in paraplegia risk in elective patients and a 5-fold reduction in acute patients. This reduction in paralysis risk has resulted in improved short- and long-term survival.
Acher
C W
CW
Department of Surgery, University of Wisconsin Hospital and Clinics, Madison 53792, USA. acher@surgery.wisc.edu
Wynn
M M
MM
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D011183:Postoperative Complications / Q000517:prevention & control; D020760:Spinal Cord Ischemia / Q000517:prevention & control; D014656:Vascular Surgical Procedures / Q000379:methods