Document Detail

Imaging of vascular remodeling after simulated thoracoabdominal aneurysm repair.
MedLine Citation:
PMID:  23010582     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: A better understanding of the response of the spinal cord blood supply to segmental artery (SA) sacrifice should help minimize the risk of paraplegia after both open and endovascular repair of thoracoabdominal aortic (TAA) aneurysms.
METHODS: Twelve female juvenile Yorkshire pigs were randomized into 3 groups and perfused with a barium-latex solution. Pigs in group 1 (control) had infusion without previous intervention. Pigs in group 2 were infused 48 hours after ligation of all SAs (T4-L5) and those in group 3 at 120 hours after ligation. Postmortem computed tomographic scanning of the entire pig enabled overall comparisons and measurement of vessel diameters in the spinal cord circulation.
RESULTS: We ligated 14.5 ± 0.8 SAs: all filled retrograde to the ligature. Paraplegia occurred in 38% of operated pigs. A significant increase in the mean diameter of the anterior spinal artery (ASA) was evident after SA sacrifice (P < .0001 for 48 hours and 120 hours). The internal thoracic and intercostal arteries also increased in diameter. Quantitative assessment showed an increase in vessel density 48 hours after ligation of SAs, reflected by an obvious increase in small collateral vessels seen on 3-dimensional reconstructions of computed tomographic scans at 120 hours.
CONCLUSIONS: Remodeling of the spinal cord blood supply--including dilatation of the ASA and proliferation of small collateral vessels--is evident at 48 and 120 hours after extensive SA sacrifice. It is likely that exploitation of this process will prove valuable in the quest to eliminate paraplegia after TAA aneurysm repair.
Sarah Geisbüsch; Deborah Schray; Moritz S Bischoff; Hung-Mo Lin; Randall B Griepp; Gabriele Di Luozzo
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-09-23
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  144     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-12     Completed Date:  2013-01-22     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1471-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Aortic Aneurysm, Thoracic / surgery*
Arteries / surgery
Barium Sulfate / diagnostic use
Behavior, Animal
Collateral Circulation
Contrast Media / diagnostic use
Dilatation, Pathologic
Disease Models, Animal
Mammary Arteries / pathology,  physiopathology,  radiography
Multidetector Computed Tomography
Neovascularization, Physiologic
Paraplegia / etiology,  pathology,  physiopathology,  radiography
Replica Techniques
Spinal Cord / blood supply*
Spinal Cord Ischemia / etiology,  pathology*,  physiopathology,  radiography
Time Factors
Vascular Surgical Procedures / adverse effects*
Grant Support
Reg. No./Substance:
0/Contrast Media; 0/Latex; 25BB7EKE2E/Barium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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