title: Paraplegia prevention branches: a new adjunct for preventing or treating spinal cord injury after endovascular repair of thoracoabdominal aneurysms.
abstract: In this report, we describe a technique that could potentially be used for both prevention and treatment of spinal cord ischemia (SCI) in endovascular repair of thoracoabdominal aneurysms. This technique involves using a specially designed endograft with side branches (paraplegia prevention branches [PPBs]), which are left patent to perfuse the aneurysmal sac and any associated lumbar or intercostal arteries in the early postoperative period. The use of PPBs with this technique is feasible and allows for a temporary controlled endoleak that may be useful for preventing or reversing spinal cord injury. This technique may be considered as an adjunct to the more standard perioperative physiological manipulations such as permissive hypertension and spinal fluid drainage.
authors.affiliation: Division of Vascular Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
authors.forename: Christos
authors.initials: C
authors.lastname: Lioupis
authors.forename: Marc Michel
authors.initials: MM
authors.lastname: Corriveau
authors.forename: Kent S
authors.initials: KS
authors.lastname: Mackenzie
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Obrand
authors.forename: Oren K
authors.initials: OK
authors.lastname: Steinmetz
authors.forename: Krassi
authors.initials: K
authors.lastname: Ivancev
authors.forename: Cherrie Z
authors.initials: CZ
authors.lastname: Abraham
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000209:etiology / Q000517:prevention & control*; D011474:Prosthesis Design; D013119:Spinal Cord Injuries / Q000209:etiology / Q000517:prevention & control*; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome