Predictors of paraplegia with current thoracoabdominal aortic aneurysm repair

Abstract

The predictors of postoperative paraplegia in our institution were perioperative hypotension and an open distal anastomosis technique. Avoidance of these risk factors might diminish the incidence of postoperative paraplegia.

Open repair of thoracoabdominal aortic aneurysms in experienced centers

“…4,6 The reintervention rate due to bleeding in the perioperative period was extracted from 14 studies and was accounted from 1.5% to 13.1%. [4][5][6][7]9,12,[15][16][17][18]22,23,26,30 Paraplegia and paraparesis rates were extracted from 23 and 14 studies, respectively. The rates ranged from 2% to 10.8% for paraplegia 14,16 and from 0% to 10% for paraparesis.…”

Extended Motor Evoked Potentials Monitoring Helps Prevent Delayed Paraplegia After Aortic Surgery

“…Selection of potential confounders to be included in the propensity score analysis was based on our clinical experience and previously published data on risk factors associated with DP‐SCI …”

“…[7][8][9][10][11]23,24,30,[32][33][34][35][36][37] We excluded others found to be more likely associated with IP-DCI, but not with DP-DCI, such as increased ACI/DAP times, 9 nonelective surgery, and extent of intercostal artery reattachment. [7][8][9][10][11]23,24,30,[32][33][34][35][36][37] We excluded others found to be more likely associated with IP-DCI, but not with DP-DCI, such as increased ACI/DAP times, 9 nonelective surgery, and extent of intercostal artery reattachment.…”

“…Selection of potential confounders to be included in the propensity score analysis was based on our clinical experience and previously published data on risk factors associated with DP-SCI. [7][8][9][10][11]23,24,30,[32][33][34][35][36][37] We excluded others found to be more likely associated with IP-DCI, but not with DP-DCI, such as increased ACI/DAP times, 9 nonelective surgery, and extent of intercostal artery reattachment.…”

Cerebrospinal fluid drainage and thoracic endovascular aneurysm repair

“…14 Furthermore, spinal cord blood flow, general hemodynamics, and hematosis also play important roles in the perioperative period. 15–17 Overall injury severity, intraoperative hypotension, and extensive aortic tissue destruction may correlate with the development of postoperative paraplegia. 4 Other mechanisms are transient, such as spasm in the microcirculation or increased spinal cord fluid (SCF) pressure following aortic crossclamping, as described in animals and humans.…”