Journal of Vascular Surgery
Volume 48, Issue 1 , Pages 47-53 , July 2008

Spinal cord complications after thoracic aortic surgery: Long-term survival and functional status varies with deficit severity

Presented at the Annual Meeting of the Society for Vascular Surgery, Baltimore, Md, Jun 6-10, 2007.

Received 7 January 2008 ,Accepted 17 February 2008.

References 

  1. Crawford ES, Crawford JL, Safi HJ, Coselli JS, Hess KR, Brooks B, et al. Thoracoabdominal aortic aneurysms: preoperative and intraoperative factors determining immediate and long-term results of operations in 605 patients. J Vasc Surg. 1986;3:389–404
  2. Cambria RP, Davison JK, Carter C, Brewster DC, Chang Y, Clark KA, et al. Epidural cooling for spinal cord protection during thoracoabdominal aneurysm repair: a five-year experience. J Vasc Surg. 2000;31:1093–1102
  3. Coselli JS, Lemaire SA, Koksoy C, Schmittling ZC, Curling PE. Cerebrospinal fluid drainage reduces paraplegia after thoracoabdominal aortic aneurysm repair: results of a randomized clinical trial. J Vasc Surg. 2002;35:631–639
  4. de Haan P, Kalkman CJ, Jacobs MJ. Pharmacologic neuroprotection in experimental spinal cord ischemia: a systematic review. J Neurosurg Anesthesiol. 2001;13:3–12
  5. Safi HJ, Miller CC, Huynh TT, Estrera AL, Porat EE, Winnerkvist AN, et al. Distal aortic perfusion and cerebrospinal fluid drainage for thoracoabdominal and descending thoracic aortic repair: ten years of organ protection. Ann Surg. 2003;238:372–380discussion 380-1
  6. Cinà CS, Laganà A, Bruin G, Ricci C, Doobay B, Tittley J, et al. Thoracoabdominal aortic aneurysm repair: a prospective cohort study of 121 cases. Ann Vasc Surg. 2002;16:631–638
  7. Conrad MF, Crawford RS, Davison JK, Cambria RP. Thoracoabdominal aneurysm repair: a 20-year perspective. Ann Thorac Surg. 2007;83:S856–S861discussion S890-2
  8. Coselli JS, Bozinovski J, LeMaire SA. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Ann Thorac Surg. 2007;83:S862–S864discussion S890-2
  9. Cinà CS, Abouzahr L, Arena GO, Laganà A, Devereaux PJ, Farrokhyar F. Cerebrospinal fluid drainage to prevent paraplegia during thoracic and thoracoabdominal aortic aneurysm surgery: a systematic review and meta-analysis. J Vasc Surg. 2004;40:36–44
  10. Safi HJ, Estrera AL, Miller CC, Huynh TT, Porat EE, Azizzadeh A, et al. Evolution of risk for neurologic deficit after descending and thoracoabdominal aortic repair. Ann Thorac Surg. 2005;80:2173–2179discussion 2179
  11. Crawford ES, Svensson LG, Hess KR, Shenaq SS, Coselli JS, Safi HJ, et al. A prospective randomized study of cerebrospinal fluid drainage to prevent paraplegia after high-risk surgery on the thoracoabdominal aorta. J Vasc Surg. 1991;13:36–45discussion 45-6
  12. Wong DR, Coselli JS, Amerman K, Bozinovski J, Carter SA, Vaughn WK, et al. Delayed spinal cord deficits after thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2007;83:1345–1355discussion 1355
  13. Bavaria JE, Appoo JJ, Makaroun MS, Verter J, Yu ZF, Mitchell RS, et al. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg. 2007;133:369–377
  14. Yokoyama O, Sakuma F, Itoh R, Sashika H. Paraplegia after aortic aneurysm repair versus traumatic spinal cord injury: functional outcome, complications, and therapy intensity of inpatient rehabilitation. Arch Phys Med Rehabil. 2006;87:1189–1194
  15. Ditunno JF, Young W, Donovan WH, Creasey G. The international standards booklet for neurological and functional classification of spinal cord injury (American Spinal Injury Association). Paraplegia. 1994;32:70–80
  16. Cambria RP. Thoracoabdominal aortic aneurysm repair: how I do it. Cardiovasc Surg. 1999;7:597–606
  17. Davison JK, Cambria RP, Vierra DJ, Columbia MA, Koustas G. Epidural cooling for regional spinal cord hypothermia during thoracoabdominal aneurysm repair. J Vasc Surg. 1994;20:304–310
  18. Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ. Experience with 1509 patients undergoing thoracoabdominal aortic operations. J Vasc Surg. 1993;17:357–368discussion 368-70
  19. Black JH, Cambria RP. Current results of open surgical repair of descending thoracic aortic aneurysms. J Vasc Surg. 2006;43(suppl A):6A–11A
  20. Estrera AL, Miller CC, Huynh TT, Porat E, Safi HJ. Neurologic outcome after thoracic and thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2001;72:1225–1230discussion 1230-1
  21. Moore AF, Klimach OE. Tetraplegia after elective abdominal aortic aneurysm repair. J Vasc Surg. 2006;44:401–403
  22. Graves DE, Frankiewicz RG, Donovan WH. Construct validity and dimensional structure of the ASIA motor scale. J Spinal Cord Med. 2006;29:39–45
  23. Jiang X, Shi E, Nakajima Y, Sato S. Postconditioning, a series of brief interruptions of early reperfusion, prevents neurologic injury after spinal cord ischemia. Ann Surg. 2006;244:148–153
  24. Marino RJ, Graves DE. Metric properties of the ASIA motor score: subscales improve correlation with functional activities. Arch Phys Med Rehabil. 2004;85:1804–1810
  25. Cambria RP, Davison JK, Zannetti S, L'Italien G, Brewster DC, Gertler JP, et al. Clinical experience with epidural cooling for spinal cord protection during thoracic and thoracoabdominal aneurysm repair. J Vasc Surg. 1997;25:234–241discussion 241-3
  26. Khoynezhad A, Donayre CE, Bui H, Kopchok GE, Walot I, White RA. Risk factors of neurologic deficit after thoracic aortic endografting. Ann Thorac Surg. 2007;83:S882–S889discussion S890-2
  27. Stone DH, Brewster DC, Kwolek CJ, Lamuraglia GM, Conrad MF, Chung TK, et al. Stent-graft versus open-surgical repair of the thoracic aorta: mid-term results. J Vasc Surg. 2006;44:1188–1197
  28. Weigang E, Hartert M, Siegenthaler MP, Beckmann NA, Sircar R, Szabò G, et al. Perioperative management to improve neurologic outcome in thoracic or thoracoabdominal aortic stent-grafting. Ann Thorac Surg. 2006;82:1679–1687
  29. Wheatley GH, Gurbuz AT, Rodriguez-Lopez JA, Ramaiah VG, Olsen D, Williams J, et al. Midterm outcome in 158 consecutive Gore TAG thoracic endoprostheses: single center experience. Ann Thorac Surg. 2006;81:1570–1577discussion 1577

 Supported in part by the Harold and June Geneen Vascular Surgery Research Fund.

 Competition of interest: none.

 CME article

PII: S0741-5214(08)00289-9

doi: 10.1016/j.jvs.2008.02.047

Journal of Vascular Surgery
Volume 48, Issue 1 , Pages 47-53 , July 2008

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