Role of Somatosensory Evoked Potentials in Predicting Outcome During Thoracoabdominal Aortic Repair

Evolution of operative strategies in open thoracoabdominal aneurysm repair

“…10 The specific comparison of this series is to our own clamp/sew method with spinal cord protection by regional hypothermia, 19 yet the overall results of the DAP cohort compare favorably with those reported from many centers where operative mortality Ͼ10% is often detailed. 2,6,29 Our initial posture toward operative simplicity with the clamp/sew approach was borne of a philosophy that an expeditious operation with minimal blood turnover would produce optimal results, particularly in elderly patients. This premise has not held true in the current series, because the higher blood turnover seen with extracorporal circulatory support appears to have improved our rate of paraplegia without increasing the rate of early mortality.…”

Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair

“…The role of SSEP has been evaluated in the past for DTAA and TAAA for its reliability in ruling out spinal dysfunction. 5 Thus the question arises: What is the role of additional neurophysiologic monitoring with intraoperative MEP measurements? Many studies have shown the reliability of MEP monitoring in predicting postoperative ND.…”

“…We previously reported 176 of these patients in our series on the role of SSEP monitoring only. 5 The 233 patients reported here underwent both SSEP and MEP monitoring intraoperatively.…”

Strategies to Minimize Risk of Spinal Cord Injury During Complex Endovascular Aortic Repair

“…Neuromonitoring has been extensively used during open surgical repair to help identify ischemia in the anterior and lateral spinal columns, which are sensitive to decreases in oxygen supply [15,16]. During open TAAA repair, this technique has helped guide selective intercostal artery reimplantation and intra-operative maneuvers designed to improve spinal cord perfusion.…”