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Neurophysiological monitoring during thoracoabdominal aortic endovascular stent graft implantation.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Weigang, Ernst Hartert, Marc Pitzer-Hartert, Katrin Luehr, Maximilian Sircar, Ronen Samson, Patrick Von Beyersdorf, Friedhelm |
| Copyright Year | 2006 |
| Abstract | 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. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ejcts/29/3/10.1016/j.ejcts.2005.11.039/3/29-3-392.pdf?Expires=1492620139&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q&Signature=Yuuv52K8mhDe3MmftL2qed6SUFhgd90zpxyzQcUew9WxCTUCVEG6Em1rY46HoAE8ZSO9qIFBk77fzA0ncGyjITbCuaEtjYnigqFBGVkpPTRukEi1mR9bCFu1sic7tktrxdJ5tPpNEidZXbvGQAuO0dM-qCZENjrsRsGqWubmaqkBA2ZXwCKnctZdgC5QCNIrxMYbDUrjOZbiGlc8wjiegxva7m3cpb4nyWz5TrwvTRJ8wROg2KTyXyXXILXXZV9jDRDjRiBK1StZUiIQBO4FeCa-lBST1HwfBjGnbfp3PU5os4L3W5d2HJ3Tsy1An2DJF3JXvRZkHzC6RN760ea0UA__ |
| PubMed reference number | 16439144v1 |
| Volume Number | 29 |
| Issue Number | 3 |
| Journal | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Cerebrospinal Fluid Chest Deploy Dissecting aneurysm of the thoracic aorta Evoked Potentials Hypothermia due to exposure Neurophysiological Monitoring Paraparesis Patients Population Parameter Reperfusion Injury Reperfusion Therapy Spinal Cord Ischemia Spinal Cord Neoplasms Stent, device Transplanted tissue torr |
| Content Type | Text |
| Resource Type | Article |
