Strategies for Preventing Spinal Cord Ischemia During Descending or Thoracoabdominal Aortic Aneurysm Surgery: Preoperative Visualization of the Adamkiewicz Artery and Intraoperative Motor-Evoked Potentials

2001 ◽  
pp. 197-205
Author(s):  
Yutaka Okita ◽  
Kenji Minatoya ◽  
Naoaki Yamada ◽  
Osamu Tagusari ◽  
Tetsuro Morota ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Aortic Aneurysm ◽  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Spinal Cord Ischemia ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aneurysm Surgery ◽  
Adamkiewicz Artery ◽  
Aortic Aneurysm Surgery

Spinal Cord Stimulation Evoked Potentials during Thoracoabdominal Aortic Aneurysm Surgery

1992 ◽  
Vol 76 (5) ◽  
pp. 689-695 ◽  
Author(s):  
Benjamin Drenger ◽  
Stephen D. Parker ◽  
Robert W. McPherson ◽  
Richard B. North ◽  
G. Melville Williams ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Aortic Aneurysm ◽  
Evoked Potentials ◽  
Spinal Cord Stimulation ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aneurysm Surgery ◽  
Aortic Aneurysm Surgery

scholarly journals Motor and Somatosensory Evoked Potentials

2008 ◽  
Vol 108 (4) ◽  
pp. 580-587 ◽  
Author(s):  
Timothy S.J. Shine ◽  
Barry A. Harrison ◽  
Martin L. De Ruyter ◽  
Julia E. Crook ◽  
Michael Heckman ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Aortic Aneurysm ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Spinal Cord Ischemia ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aortic Aneurysms ◽  
Aortic Cross Clamp ◽  
Surgical Interventions

Background Paraplegia is a devastating complication for patients undergoing repair of thoracoabdominal aortic aneurysms. A monitor to detect spinal cord ischemia is necessary if anesthesiologists are to intervene to protect the spinal cord during aortic aneurysm clamping. Methods The medical records of 60 patients who underwent thoracoabdominal aortic aneurysm repair with regional lumbar epidural cooling with evoked potential monitoring were reviewed. The authors analyzed latency and amplitude of motor evoked potentials, somatosensory evoked potentials, and H reflexes before cooling and clamping, after cooling and before clamping, during clamping, and after release of aortic cross clamp. Results Twenty minutes after the aortic cross clamp was placed, motor evoked potentials had 88% sensitivity and 65% specificity in predicting spinal cord ischemia. The negative predictive value of motor evoked potentials at 20 min after aortic cross clamping was 96%. Conclusions Rapid loss of motor evoked potentials or H reflexes after application of the aortic cross clamp identifies a subgroup of patients who are at high risk of developing spinal cord ischemia and in whom aggressive anesthetic and surgical interventions may be justified.

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