Journal article
Spinal cord perfusion protection for thoraco-abdominal aortic aneurysm surgery
Current opinion in anaesthesiology, Vol.32(1), pp.72-79
02/2019
DOI: 10.1097/ACO.0000000000000670
PMID: 30507678
Abstract
Spinal cord ischemia (SCI) is a devastating complication after open or endovascular aortic repair for thoracoabdominal aortic disease. The underlying pathogenesis is not fully understood but appears multifactorial. Multiple spinal cord protection strategies and monitoring techniques are currently utilized with variable results seen. The purpose of this review is to summarize important and recent findings related to cause, monitoring and impact of multiple spinal cord protection strategies.
Recent data suggests collateral blood flow as the major determinant of spinal cord perfusion instead of individual intercostal vessels, potential role of transcutaneous near-infrared spectroscopy for monitoring of spinal cord perfusion and positive impact of implementing multimodal spinal cord protection strategies on reducing the risk of SCI.
SCI leading to paraplegia is a multifactorial complication that remains a major concern in complex aortic surgeries. Although there are no sufficient data to document the efficacy of spinal cord protection techniques individually, their effect on lowering the risk of SCI is most evident when used concomitantly using a multimodal approach that encompasses the perioperative and early postoperative period.
Details
- Title: Subtitle
- Spinal cord perfusion protection for thoraco-abdominal aortic aneurysm surgery
- Creators
- Lovkesh Arora - Department of Anesthesia and Critical CareMaen Aboul Hosn - Department of Vascular Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
- Resource Type
- Journal article
- Publication Details
- Current opinion in anaesthesiology, Vol.32(1), pp.72-79
- Publisher
- United States
- DOI
- 10.1097/ACO.0000000000000670
- PMID
- 30507678
- ISSN
- 0952-7907
- eISSN
- 1473-6500
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Surgery; Anesthesia
- Record Identifier
- 9984007163502771
Metrics
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