Extended Motor Evoked Potentials Monitoring Helps Prevent Delayed Paraplegia After Aortic Surgery

Abstract

MEPs detect the lowest systemic blood pressure that ensures appropriate spinal cord perfusion in the postoperative period. Thus, they inform the hemodynamic management of patients post-OTAAR, particularly in the absence of a reliable neurological exam.

Single-staged hybrid repair of extent II thoracoabdominal aortic aneurysm with infrarenal abdominal aortic occlusion

“…Throughout the procedure, other forms of previously established multimodal organ protection were also used. 5 , 6 , 7 , 8 We placed a spinal cord drain at the start of the case for postoperative spinal cord perfusion pressure control. An LHB was established and used to perfuse the pelvis and lower extremities through the patent left femoral system and to perfuse the viscera and kidneys through direct access of the aorta.…”

Motor-Evoked Potential Monitoring With Multi-train Electrical Stimulation During Thoracoabdominal Aortic Aneurysm Surgery: A Case Report

“…Intraoperative motor-evoked potential (MEP) monitoring has been used in many centers to avoid postoperative paraplegia due to ischemic spinal cord injury during thoracoabdominal aortic aneurysm (TAAA) surgery. However, false-positive results (decreased or absent waveforms without spinal cord ischemia) are common and their utility is unknown [1][2][3]. False-positive MEP frequently occurs during hypothermia and extracorporeal circulation for brain protection during surgery [2].…”