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Ann Thorac Surg 1990;49:528-536
© 1990 The Society of Thoracic Surgeons
Departments of Surgery and Neurophysiology, Baylor College of Medicine and The Methodist Hospital, Houston, Texas USA
* Address reprint requests to Dr Svensson, Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030.
One source of paraplegia after aortic operations is the failure to reattach the spinal cord blood supply, the origins of which are not evident at operation. This report is concerned with a rapid new method of identifying these vessels intraoperatively. In 9 pigs, a specially designed catheter with platinum and stainless steel electrodes was inserted intrathecally. Saline solution saturated with hydrogen was injected sequentially into arterial ostia at T-15 to L-4 inclusive, and the generated current impulses from the conditioned platinum electrode were recorded. Of 90 potential segmental arteries supplying the spinal cord, 28 gave rise to spinal radicular arteries. Hydrogen-induced current impulses correctly located 25 of the radicular arteries and all those larger than 180 µm in diameter. When injected with indigo carmine, the vessels localized by the hydrogen-induced current impulses filled the entire anterior spinal artery from the low thoracic to the sacral region, whereas injection of the other vessels did not show filling. After refinement and testing for safety, this method has been employed clinically to rapidly localize and reattach routes of critical cord circulation.
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