Document Detail

Spinal cord perfusion and protection during descending thoracic and thoracoabdominal aortic surgery: the collateral network concept.
MedLine Citation:
PMID:  17257943     Owner:  NLM     Status:  MEDLINE    
In the last two decades, as an increasing number of patients with descending thoracic and thoracoabdominal aneurysms are being diagnosed and treated, a more sophisticated understanding of spinal cord perfusion has become important in the attempt to minimize the frequency of spinal cord injury. The synthesis of information from laboratory studies and clinical experience has led to the collateral network concept, a framework for understanding spinal cord perfusion and thereby improving spinal cord protection during treatment of aneurysmal disease of the aorta distal to the left subclavian artery. Application of principles based on the collateral network concept has resulted in falling rates of spinal cord injury, which now approach 1% in descending thoracic aneurysm resection and less than 10% in extensive thoracoabdominal resections. These accomplishments suggest that, with further investigation, routine sacrifice of segmental aortic branches can be carried out in a way that will allow surgical and endovascular therapy of extensive distal aortic aneurysms without neurologic injury.
Randall B Griepp; Eva B Griepp
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  83     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-29     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  S865-9; discussion S890-2     Citation Subset:  AIM; IM    
Department of Cardiothoracic Surgery, Mount Sinai School of Medicine, New York, New York, USA.
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MeSH Terms
Aortic Aneurysm, Abdominal / physiopathology,  surgery*
Aortic Aneurysm, Thoracic / physiopathology,  surgery*
Collateral Circulation
Hypothermia, Induced*
Models, Cardiovascular
Neuroprotective Agents / therapeutic use*
Regional Blood Flow
Spinal Cord / blood supply*,  drug effects
Vascular Surgical Procedures*
Reg. No./Substance:
0/Neuroprotective Agents

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

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