| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1995;59:245-252
© 1995 The Society of Thoracic Surgeons
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia
Spinal cord injury occurring as the result of surgical repair of thoracic and thoracoabdominal aortic disease remains a devastating complication. The incidence of postoperative neurologic deficits varies from 4% to 38%. Factors associated with a greater risk for injury include the presence of dissection or extensive thoracoabdominal disease, and a prolonged cross-clamp time. Spinal cord ischemia initiates a deleterious cascade of biochemical events that ultimately result in an increased intracellular calcium concentration. Calcium-activated proteases, lipases, and nucleases mediate the processes that cause cell injury. The accumulation of oxygen-derived free radicals and the occurrence of hyperemia during reperfusion are also contributing causes of spinal cord injury. Increasing the spinal cord blood flow with shunts, oxygenated bypass circuits, cerebrospinal fluid drainage, the intrathecal administration of vasodilators, and the reattachment of intercostal arteries has been tried in an effort to increase spinal cord perfusion. Pharmacologically based measures to prevent spinal cord injury have been pursued, and these have consisted of hypothermia, anesthetic agents, calcium channel blockers, free radical scavengers, and immune system modulation. However, no single technique has proved to be consistently effective in preventing ischemia-induced spinal cord injury.
This article has been cited by other articles:
|
|
 |
|
  R. A. Kahn, M. E. Stone, and D. M. Moskowitz Anesthetic Consideration for Descending Thoracic Aortic Aneurysm Repair Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2007; 11(3): 205 - 223. [Abstract] [PDF]
|
|
|
|
|
|
I. Dorotta, P. Kimball-Jones, and R. Applegate II Deep hypothermia and circulatory arrest in adults. Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2007; 11(1): 66 - 76. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Biglioli, F. Barili, M. Fusari, F. Grillo, and M. Roberto The Quick simple clamping technique for the repair of descending aortic aneurysm MMCTS, November 10, 2006; 2006(1110): 1941. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Biglioli, M. Roberto, A. Cannata, A. Parolari, and R. Spirito Paraplegia after iatrogenic extrinsic spinal cord compression after descending thoracic aorta repair: Case report and literature review J. Thorac. Cardiovasc. Surg., August 1, 2002; 124(2): 407 - 410. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Lachat, T. Pfammatter, H. Witzke, E. Bernard, U. Wolfensberger, A. Kunzli, and M. Turina Acute traumatic aortic rupture: early stent-graft repair Eur. J. Cardiothorac. Surg., June 1, 2002; 21(6): 959 - 963. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Hessel Bypass Techniques for Descending Thoracic Aortic Surgery Seminars in Cardiothoracic and Vascular Anesthesia, November 1, 2001; 5(4): 293 - 320. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Wada, H. Yao, T. Miyamoto, S. Mukai, and M. Yamamura Prevention and detection of spinal cord injury during thoracic and thoracoabdominal aortic repairs Ann. Thorac. Surg., July 1, 2001; 72(1): 80 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kunihara, S. Sasaki, N. Shiiya, T. Miyatake, N. Mafune, and K. Yasuda Proinflammatory cytokines in cerebrospinal fluid in repair of thoracoabdominal aorta Ann. Thorac. Surg., March 1, 2001; 71(3): 801 - 806. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Y.P. Wan, G. D. Angelini, A. J. Bryan, I. Ryder, and M. J. Underwood Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery Eur. J. Cardiothorac. Surg., February 1, 2001; 19(2): 203 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A T. Ulus, U. Tutun, S. Surucu, N. Apaydin, P. Gokce, S F. Katircioglu, A T. Ulus, U. Tutun, S. Surucu, N. Apaydin, et al. Functional Outcome in Model of Spinal Cord Ischemia: Use of Enoximone Asian Cardiovasc Thorac Ann, September 1, 2000; 8(3): 216 - 220. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ueda, H. Shimizu, A. Mori, I. Kashima, K. Moro, and S. Kawada Selective perfusion of segmental arteries in patients undergoing thoracoabdominal aortic surgery Ann. Thorac. Surg., July 1, 2000; 70(1): 38 - 43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kunihara, S. Sasaki, N. Shiiya, H. Ishikura, Y. Kawarada, A. Matsukawa, and K. Yasuda Lazaroid reduces production of IL-8 and IL-1 receptor antagonist in ischemic spinal cord injury Ann. Thorac. Surg., March 1, 2000; 69(3): 792 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Lang-Lazdunski, K. Matsushita, L. Hirt, C. Waeber, J.-P. G. Vonsattel, M. A. Moskowitz, and W. D. Dietrich Spinal Cord Ischemia : Development of a Model in the Mouse Editorial Comment: Development of a Model in the Mouse Stroke, January 1, 2000; 31(1): 208 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Ohno, N. Ohno, K.-J. Miyamoto, and T.-A. Miyamoto Taurine Potentiates the Efficacy of Hypothermia Asian Cardiovasc Thorac Ann, December 1, 1999; 7(4): 267 - 271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Mastroroberto and M. Chello EMERGENCY THORACOABDOMINAL AORTIC ANEURYSM REPAIR: CLINICAL OUTCOME J. Thorac. Cardiovasc. Surg., September 1, 1999; 118(3): 477 - 481. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Biglioli, R. Spirito, M. Porqueddu, M. Agrifoglio, G. Pompilio, A. Parolari, L. Dainese, and E. Sisillo Quick, simple clamping technique in descending thoracic aortic aneurysm repair Ann. Thorac. Surg., April 1, 1999; 67(4): 1038 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. L. Kron Surgery of the Thoracic Aorta Ann. Thorac. Surg., November 1, 1997; 64(5): 1555 - 1558. [Abstract] [Full Text]
|
|
|
|
 |
|
 K. D. Robinson, R. T. Gregory, R. G. Gayle, F. N. Parent, R. J. Demasi, and J. R. Wheeler Lumbosacral Plexopathy: A Complication of Ruptured Aortoiliac Aneurysms: Three Case Reports Vascular and Endovascular Surgery, July 1, 1997; 31(4): 501 - 507. [Abstract] [PDF]
|
|
|
|
|
|
A. Mori, T. Ueda, T. Nakamichi, M. Yasudo, R. Aeba, H. Odaguchi, A. Mitsumaru, T. Ito, R. Yozu, A. Koto, et al. Detrimental Effects of Exogenous Glutamate on Spinal Cord Neurons During Brief Ischemia In Vivo Ann. Thorac. Surg., April 1, 1997; 63(4): 1057 - 1062. [Abstract] [Full Text]
|
|
|
|
|
|
A. C. Galloway, D. S. Schwartz, A. T. Culliford, G. H. Ribakove, E. A. Grossi, R. A. Esposito, F. G. Baumann, J. Delianides, F. C. Spencer, and S. B. Colvin Selective Approach to Descending Thoracic Aortic Aneurysm Repair: A Ten-Year Experience Ann. Thorac. Surg., October 1, 1996; 62(4): 1152 - 1157. [Abstract] [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
