Cold blood spinoplegia under motor-evoked potential monitoring during thoracic aortic surgery

Abstract

Cold blood infusion accelerates motor-evoked potential changes and might enable decision making regarding the need for reconstruction of multidetector computed tomography-defined Adamkiewicz arteries. Cold blood-loaded motor-evoked potential is beneficial to minimize Adamkiewicz artery reconstruction time and limit spinal cord ischemia.

Spinal cord injury following thoracic and thoracoabdominal aortic repairs

“…[86][87][88][89][90][91][92][93][94][95][96][97] Preoperative identification of the artery of Adamkiewicz by magnetic resonance angiography or computed tomography-angiography further helps to prevent SCI. 29,[98][99][100][101] TEVAR has recently been increasingly utilized in the management of thoracic aortic aneurysms. Because SCI is also associated with TEVAR, we included TEVAR along with open repairs during our analysis.…”

Invited Commentary

“…However, most previous studies related to MEP monitoring during thoracic and thoracoabdominal aortic repair concerned decreased MEP. Significant MEP decrease was defined as an MEP amplitude to less than 50% or 25% of the baseline, and MEP increase was defined as a restoration of MEP followed by aortic intervention and an MEP decrease [3]. In this situation, what does MEP increase imply?…”

Role of Induced Hypothermia in Thoracoabdominal Aortic Aneurysm Surgery

“…Takahashi et al showed that segmental cold blood infusion, which accelerates a decline in MEPs, is useful for determining when specific arteries need to be reconstructed (e.g., artery of Adamkiewicz). This technique was found to minimize reconstruction time and limit spinal cord damage (Takahashi et al, 2011).…”