title: Spinal cord function monitoring during endovascular treatment of thoracoabdominal aneurysms: implications for staged procedures.
abstract: OBJECTIVE
  Spinal cord ischemia is a well-known complication in the treatment of thoracoabdominal aneurysms (TAAA). Despite the fact that endovascular treatment of TAAA is less invasive, spinal cord ischemia rate is not reduced if compared to open repair.
  
  
  METHODS
  We report the results of our experience of spinal cord function monitoring by measuring motor evoked potentials (MEP) during endovascular treatment of TAAA type II and III. Depending on the level of the MEPs the decision is made whether to stage the procedure or not. We treated ten patients according to this protocol.
  
  
  RESULTS
  In two patients, MEPs decreased 50% or more and procedures were staged. Both experienced no neurological complications after first and second procedure. No MEPs decrease was seen during the second procedures. One of the other eight patients had a temporary right lower leg pararesis.
  
  
  CONCLUSIONS
  In conclusion we state that our first experience demonstrates the value of assessing spinal cord function during extensive endovascular TAAA repair with subsequent strategies to prevent paraplegia.
authors: Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. gwh.schurink@mumc.nl
authors: G W H
authors: GW
authors: Schurink
authors: M W
authors: MW
authors: De Haan
authors: A G
authors: AG
authors: Peppelenbosch
authors: W
authors: W
authors: Mess
authors: M J
authors: MJ
authors: Jacobs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000503:physiopathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D004558:Electric Stimulation; D004576:Electromyography; D057510:Endovascular Procedures / Q000009:adverse effects; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D020335:Paraparesis / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D010264:Paraplegia / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D011237:Predictive Value of Tests; D052097:Quadriceps Muscle / Q000294:innervation*; D012039:Regional Blood Flow; D013116:Spinal Cord / Q000098:blood supply* / Q000503:physiopathology*; D020760:Spinal Cord Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D016896:Treatment Outcome