Spinal cord stimulation evoked potentials during thoracoabdominal aortic aneurysm surgery

1993 ◽  
Vol 18 (6) ◽  
pp. 1084-1085
Author(s):  
Joseph S. Coselli
Keyword(s):  
Spinal Cord ◽  
Aortic Aneurysm ◽  
Evoked Potentials ◽  
Spinal Cord Stimulation ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aneurysm Surgery ◽  
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

Changes in Cerebrospinal Fluid Pressure and Lactate Concentrations during Thoracoabdominal Aortic Aneurysm Surgery

1997 ◽  
Vol 86 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Benjamin Drenger ◽  
Stephen D. Parker ◽  
Steven M. Frank ◽  
Charles Beattie
Keyword(s):  
Spinal Cord ◽  
Cerebrospinal Fluid ◽  
Aortic Aneurysm ◽  
Aortic Surgery ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aortic Occlusion ◽  
Aneurysm Surgery ◽  
Csf Pressure ◽  
Csf Lactate ◽  
Aortic Aneurysm Surgery

Background Although ischemic injury to the spinal cord is a well-known complication of aortic surgery, no metabolic markers have been identified as predictors of an adverse outcome. This study evaluated the effect of cerebrospinal fluid (CSF) drainage, with and without distal femoral perfusion or moderate hypothermia on blood and CSF lactate concentrations and CSF pressure during thoracoabdominal aortic aneurysm surgery. Methods Three nonconcurrent groups of patients were studied prospectively: patients with normal body temperature (35 degrees C) but without distal femoral bypass (n = 6), patients with normal body temperature with bypass (n = 7), and patients with hypothermia (30 degrees C) and bypass (n = 8). In all patients, CSF pressure was recorded before, during, and after aortic cross-clamping. During the surgical repair, CSF drainage was performed using a 4-Fr intrathecal silicone catheter. Blood and CSF lactate concentrations were measured throughout the operation. Results Significant increases in blood (490%) and CSF (173%) lactate concentrations were observed during and after thoracic aortic occlusion in patients with normothermia and no bypass (P < 0.02 and 0.05, respectively). Distal perfusion attenuated the increase in both blood and CSF lactate (P < 0.01), and a further reduction was achieved with hypothermia of 30 degrees C (P < 0.001). Patients who became paraplegic showed a greater increase in CSF lactate concentrations after aortic clamp release compared with those who suffered no neurological damage (275% vs. 123% of baseline; P < 0.05). Increased CSF pressure of 42-60% (P < 0.005) was noted soon after thoracic aortic occlusion, both with and without distal femoral bypass. Conclusions Incremental reductions in CSF lactate concentrations were achieved using distal femoral bypass and hypothermia. The reduction in CSF lactate correlated with the methods used to protect the spinal cord during thoracoabdominal aortic aneurysm surgery and was associated with better outcome. Decompression by distal bypass of the hemodynamic overload caused by aortic occlusion was insufficient to eliminate the acute increase in CSF pressure. Cerebrospinal fluid lactate measurements during high aortic surgery may accurately represent the spinal cord metabolic balance.

Somatosensory Evoked Potentials During Exclusion and Reperfusion of Critical Aortic Segments in Thoracoabdominal Aortic Aneurysm Surgery

1994 ◽  
Vol 9 (6) ◽  
pp. 692-702 ◽  
Author(s):  
Marc A.A.M. Schepens ◽  
Eduard H.J.F. Boezeman ◽  
Ruben P.H.M. Hamerlijnck ◽  
Huub ter Beek ◽  
Freddy E.E. Vermeulen
Keyword(s):  
Aortic Aneurysm ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Aneurysm Surgery ◽  
Aortic Aneurysm Surgery
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