6533b7d0fe1ef96bd125b857
RESEARCH PRODUCT
Contemporary spinal cord protection during thoracic and thoracoabdominal aortic surgery and endovascular aortic repair: a position paper of the vascular domain of the European Association for Cardio-Thoracic Surgery†.
Marc A.a.m. SchepensJean BachetRoberto Di BartolomeoLars LönnThierry CarrelCarlos A. MestresMartin GrabenwögerMartin CzernyMartin CzernyMarc HartertChristian D. EtzErnst Weigangsubject
Pulmonary and Respiratory Medicinemedicine.medical_specialtyHeelIntraoperative Neurophysiological MonitoringIschemiaThoracic Surgical ProcedureAorta Thoracic610 Medicine & healthSpinal cord injuryThoracic aorta142-005 142-0052705 Cardiology and Cardiovascular Medicinemedicine.arterymedicineThoracic aortaHumansAorta Abdominal610 Medicine & healthSpinal cord injuryEndovascular ProcedureAortic Aneurysm ThoracicTEVARbusiness.industrySpinal Cord IschemiaEndovascular ProceduresThoracoabdominal aortaGeneral MedicineThoracic Surgical Proceduresmedicine.diseaseSpinal cordSurgery2746 SurgeryEuropemedicine.anatomical_structureSpinal CordCardiothoracic surgery2740 Pulmonary and Respiratory MedicineAnesthesiaPractice Guidelines as TopicSurgeryParaplegiaComplicationbusinessCardiology and Cardiovascular MedicineHumandescription
Ischaemic spinal cord injury (SCI) remains the Achilles heel of open and endovascular descending thoracic and thoracoabdominal repair. Neurological outcomes have improved coincidentially with the introduction of neuroprotective measures. However, SCI (paraplegia and paraparesis) remains the most devastating complication. The aim of this position paper is to provide physicians with broad information regarding spinal cord blood supply, to share strategies for shortening intraprocedural spinal cord ischaemia and to increase spinal cord tolerance to transitory ischaemia through detection of ischaemia and augmentation of spinal cord blood perfusion. This study is meant to support physicians caring for patients in need of any kind of thoracic or thoracoabdominal aortic repair in decision-making algorithms in order to understand, prevent or reverse ischaemic SCI. Information has been extracted from focused publications available in the PubMed database, which are cohort studies, experimental research reports, case reports, reviews, short series and meta-analyses. Individual chapters of this position paper were assigned and after delivery harmonized by Christian D. Etz, Ernst Weigang and Martin Czerny. Consequently, further writing assignments were distributed within the group and delivered in August 2014. The final version was submitted to the EJCTS for review in September 2014.
year | journal | country | edition | language |
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2015-01-01 |