Spinal cord protection during thoracoabdominal aneurysm repair.
Spinal cord injury after thoracoabdominal aortic surgery remains a devastating and unpredictable complication, caused by clamping of the thoracoabdominal aorta, resulting in exclusion of blood flow in critical and essential intercostal arteries. Various protective methods against spinal cord ischemia have been proposed and performed clinically. These include preoperative spinal angiography, distal aortic perfusion, hypothermia, reattachment of the intercostal artery, cerebrospinal fluid drainage, administration of neuroprotective agents, and monitoring of somatosensory and motor-evoked potentials. The information to date suggests that multimodality approaches should be used to prevent spinal cord injury after thoracic and thoracoabdominal aneurysm repair.
Tabayashi
Koichi
K
Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D018696:Neuroprotective Agents / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D011379:Prognosis; D011859:Radiography; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000517:prevention & control*; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods
D018696:Neuroprotective Agents