Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Oct 1;12(10):1629.
doi: 10.3390/jpm12101629.

Prevention of Spinal Cord Injury during Thoracoabdominal Aortic Aneurysms Repair: What the Anaesthesiologist Should Know

Federico Marturano  1 , Fulvio Nisi  2 , Enrico Giustiniano  2 , Francesco Benedetto  2   3 , Federico Piccioni  2 , Umberto Ripani  4
Affiliations
Review

Prevention of Spinal Cord Injury during Thoracoabdominal Aortic Aneurysms Repair: What the Anaesthesiologist Should Know

Federico Marturano et al. J Pers Med. .

Abstract

Thoraco-abdominal aortic repair is a high-risk surgery for both mortality and morbidity. A major complication is paraplegia-paralysis due to spinal cord injury. Modern thoracic and abdominal aortic aneurysm repair techniques involve multiple strategies to reduce the risk of spinal cord ischemia during and after surgery. These include both surgical and anaesthesiologic approaches to optimize spinal cord perfusion by staging the procedure, guaranteeing perfusion of the distal aorta through various techniques (left atrium-left femoral artery by-pass) by pharmacological and monitoring interventions or by maximizing oxygen delivery and inducing spinal cord hypothermia. Lumbar CSF drainage alone or in combination with other techniques remains one of the most used and effective strategies. This narrative review overviews the current techniques to prevent or avoid spinal cord injury during thoracoabdominal aortic aneurysms repair.

Keywords: CSF drainage; aneurysm; aortic repair; neuromonitoring; neuroprotection; vascular surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Adnan Z., Rizvi M.D. Incidence, prevention and management in spinal cord protection during TEVAR. J. Vasc. Surg. 2010;52:86–90. - PubMed
    1. Okita Y. Fighting spinal cord complication during surgery for thoracoabdominal aortic diseas. Gen. Thorac. Cardiovasc. Surg. 2011;59:79–90. doi: 10.1007/s11748-010-0668-x. - DOI - PubMed
    1. Cheung A.T., Weiss S.J., McGarvey M.L., Stecker M.M., Hogan M.S., Escherich A., Bavaria J.E. Interventions for reversing delayed onset postoperative paraplegia after thoracic aortic reconstruction. Ann. Thorac. Surg. 2002;74:413–421. doi: 10.1016/S0003-4975(02)03714-1. - DOI - PubMed
    1. Melissano G., Bertoglio L., Rinaldi E., Leopardi M., Chiesa R. An anatomical rewiew of spinal cord blood supply. J. Cardiovasc. Surg. 2015;56:699–706. - PubMed
    1. Cheung A.T., Pochettino A., McGarvey M.L., Appoo J.J., Fairman R.M., Carpenter J.P., Moser W.G., Woo E.Y., Bavaria J.E. Strategies to manage paraplegia risk after endovascular stent repair of descending thoracic aortic aneurysms. Ann. Thorac. Surg. 2005;80:1280–1289. doi: 10.1016/j.athoracsur.2005.04.027. - DOI - PubMed

LinkOut - more resources