Direct Intraoperative Neurologic Assessment to Monitor Spinal Cord Ischemia During Thoracoabdominal Aneurysm Endovascular Repair.

SPINAL CORD ISCHEMIA (SCI) resulting in paraplegia or paraparesis is one of the most feared and harmful complications after thoracoabdominal aneurysm repair. 1 Geisbüsch S. Schray D. Bischoff M.S. et al. Imaging of vascular remodeling after simulated thoracoabdominal aneurysm repair. J Thorac Cardiovasc Surg. 2012; 144: 1471-1478 Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar SCI risk after aortic thoracoabdominal aneurysm endovascular repair (TEVAR) is 0% to 33%. 2 Verzini F. Loschi D. De Rango P. et al. Current results of total endovascular repair of thoracoabdominal aortic aneurysm. J Cardiovasc Surg (Torino). 2014; 55: 9e-19 PubMed Google Scholar It is increased by multiple factors, including stent graft length and number of intercostal and lumbar arteries covered. 3 Jayia P. Constantinou J. Hamilton H. et al. Temporary perfusion branches to decrease spinal cord ischemia in the endovascular treatment of thoraco-abdominal aortic aneurysms: Based on a presentation at the 2013 VEITH Symposium, November 19-23, 2013 (New York, NY, USA). Aorta (Stamford). 2015; 3: 56-60 Google Scholar