| Neurophysiological monitoring during thoracoabdominal aortic endovascular stent graft implantation. | |
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MedLine Citation:
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PMID: 16439144 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of this study was to evaluate the benefit of neurophysiological monitoring during thoracic and thoracoabdominal endovascular stent graft implantation. METHODS: The spinal cords of 21 patients undergoing endovascular stent graft implantation on the thoracic and thoracoabdominal aorta were monitored with transcranial motor-evoked potentials (tcMEP) and somatosensory-evoked potentials (SSEP). All patients underwent mild systemic hypothermia (34-35 degrees C), constant cerebrospinal fluid (CSF) pressure and vital parameter monitoring. If CSF pressure exceeded 15 mmHg, CSF-drainage was carried out. RESULTS: Three of the 21 patients (14%) exhibited short-term loss of tcMEP and SSEP after the deployment of the self-expanding endoprosthesis. We observed an intraoperative recovery of the evoked potentials in all cases. CSF-drainage was necessary in three of them. One patient, whose potentials were stable intraoperatively, developed paraparesis 3 weeks after the intervention. CONCLUSIONS: Neurophysiological monitoring has proved to be an ideal monitoring method to detect spinal cord ischemia during thoracic and thoracoabdominal endovascular stent graft implantation. Due to the advantages of endovascular therapy (no aortic cross-clamping, continuous distal perfusion, and no reperfusion injury), changes in potentials were seldom observed. |
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Authors:
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Ernst Weigang; Marc Hartert; Michael P Siegenthaler; Katrin Pitzer-Hartert; Maximilian Luehr; Ronen Sircar; Patrick von Samson; Friedhelm Beyersdorf |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2006-01-24 |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 29 ISSN: 1010-7940 ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-02-13 Completed Date: 2006-04-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 392-6 Citation Subset: IM |
Affiliation:
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Department of Cardiovascular Surgery, University Hospital Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany. weigang@ch11.ukl.uni-freiburg.de |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Anesthesia, General / methods Aortic Aneurysm, Abdominal / radiography, surgery* Aortic Aneurysm, Thoracic / radiography, surgery* Blood Vessel Prosthesis Implantation / adverse effects*, methods Electric Stimulation / methods Evoked Potentials, Motor Evoked Potentials, Somatosensory Female Humans Intraoperative Complications / diagnosis Male Middle Aged Monitoring, Intraoperative / methods* Postoperative Complications / prevention & control Spinal Cord / physiopathology Spinal Cord Ischemia / diagnosis*, etiology, prevention & control Stents Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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