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Spinal cord protection in thoracoabdominal aortic aneurysm surgery: a multimodal approach
- Source :
- The Journal of cardiovascular surgery. 62(4)
- Publication Year :
- 2021
-
Abstract
- Spinal cord injury (SCI) is one major complication of open and endovascular thoracic and thoracoabdominal aortic aneurysm repair. Despite numerous neuroprotective adjuncts, the incidence of SCI remains high. This review article discusses established and novel adjuncts for spinal cord protection, including priming and preconditioning of the paraspinal collateral network, intraoperative systemic hypothermia, distal aortic perfusion, motor- and somatosensory evoked potentials and noninvasive cnNIRS monitoring as well as peri- and postoperative drainage of cerebrospinal fluid. Regardless of the positive influence of many of these strategies on neurologic outcome, to date no strategy assures definitive preservation of spinal cord integrity during and after aortic aneurysm repair.
- Subjects :
- medicine.medical_specialty
030204 cardiovascular system & hematology
Neuroprotection
03 medical and health sciences
Aortic aneurysm
0302 clinical medicine
Cerebrospinal fluid
Monitoring, Intraoperative
medicine
Humans
Spinal cord injury
Aortic Aneurysm, Thoracic
business.industry
Spinal Cord Ischemia
Endovascular Procedures
Multimodal therapy
General Medicine
medicine.disease
Spinal cord
Review article
Surgery
medicine.anatomical_structure
030228 respiratory system
Spinal Cord
Somatosensory evoked potential
cardiovascular system
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1827191X
- Volume :
- 62
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Journal of cardiovascular surgery
- Accession number :
- edsair.doi.dedup.....2025c46f95a8363d200b3ebf104e5c09