Single-clamp technique for aneurysms of the descending thoracic aorta: report of 132 consecutive cases✩

Cooley, Denton A.; Golino, Alessandro; Frazier, O. H.

doi:10.1016/s1010-7940(00)00499-1

Cited by 46 publications

(30 citation statements)

References 22 publications

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“…The principal problem in the surgical repair of descending or thoracic abdominal aneurysms is still paraplegia, with an incidence reported at between 4 and 32% in recent works [140][141][142][143][144][145][146][147][148][149][150][151]. Indeed, medullar injury still is a devastating event for the patient, family and surgical staff.…”

Section: Descending Aorta -Thoracic-abdominalmentioning

confidence: 99%

Diretrizes para o tratamento cirúrgico das doenças da aorta da Sociedade Brasileira de Cirurgia Cardiovascular

Albuquerque¹,

Braile²,

Fonseca³

et al. 2006

Rev Bras Cir Cardiovasc

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Section: Descending Aorta -Thoracic-abdominalmentioning

confidence: 99%

Diretrizes para o tratamento cirúrgico das doenças da aorta da Sociedade Brasileira de Cirurgia Cardiovascular

Albuquerque¹,

Braile²,

Fonseca³

et al. 2006

Rev Bras Cir Cardiovasc

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“…A principal preocupação na correção cirúrgica dos aneurismas descendentes ou toraco-abdominais ainda é a paraplegia, com incidência relatada entre 4 e 32% nos trabalhos recentes [145][146][147][148][149][150][151][152][153][154][155][156] . De fato, a injúria medular continua a ser um evento devastador para paciente, família e equipe cirúr-gica.…”

Section: Aorta Descendente -Toraco-abdominalunclassified

Diretrizes para a cirurgia das doenças da aorta

Albuquerque¹,

Palma²,

Braile³

et al. 2004

Arq. Bras. Cardiol.

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“…[5][6][7] Progression of the injury and a delay in symptom onset suggest that the pathological mechanisms involve not only the initial ischemic event, but ongoing molecular insults during the reperfusion phase. Some of the first characterizations of spinal cord injury after aortic procedures reported a total incidence of 15% to 20%, with slightly more than half of those occurring in a delayed fashion.…”

mentioning

confidence: 99%

The Evolution of Chemokine Release Supports a Bimodal Mechanism of Spinal Cord Ischemia and Reperfusion Injury

et al. 2012

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Background-Paraplegia remains a devastating complication of thoracic aortic surgery. The mechanism of the antecedent spinal cord ischemia and reperfusion injury (IR) remains poorly described. IR involves 2 injuries, an initial ischemic insult and subsequent inflammatory amplification of the injury. This mechanism is consistent with the clinical phenomenon of delayed onset paraplegia. This study sought to characterize the inflammatory response in the spinal cord after IR and hypothesized that this would support a bimodal mechanism of injury. Methods and Results-Male C57Bl/6 mice were subjected to 5 minutes of aortic arch and left subclavian occlusion with subsequent reperfusion to generate spinal cord ischemia. Functional outcomes were scored at 12-hour intervals. Spinal cords were harvested after 0, 6, 12, 18, 24, 36, and 48 hours of reperfusion. Cytokine levels were analyzed using a mouse magnetic bead-based multiplex immunoassay. Inflammatory chemokine concentrations (interleukin [IL]-1␤, IL-6, keratinocyte-derived cytokine, macrophage inflammatory protein-1␣, monocyte chemotactic protein-1, RANTES, and tumor necrosis factor-␣) peaked at 6 hours and 36 to 48 hours after reperfusion. Functional scores reflected initial gain in function with subsequent decline, inversely proportional to cytokine levels. Immunofluorescent staining demonstrated microglia activation at 12 and 48 hours. Conclusions-Spinal cord ischemia and reperfusion injury occurs in 2 phases, correlating to increases in inflammatory chemokines release and microglial activation. These observations chronologically parallel the too-common clinical syndrome of delayed-onset paraplegia. Understanding the molecular pathogenesis of this injury may allow future intervention to prevent this devastating complication. (Circulation. 2012;126[suppl 1]:S110 -S117.)

show abstract

Single-clamp technique for aneurysms of the descending thoracic aorta: report of 132 consecutive cases✩

Abstract: The single-clamp technique yielded an acceptable complication rate, and the mortality was comparable to that seen after the use of more complex methods. For satisfactory results, the cross-clamp time should not exceed 30 min.

Cited by 46 publications

References 22 publications

Diretrizes para o tratamento cirúrgico das doenças da aorta da Sociedade Brasileira de Cirurgia Cardiovascular

Diretrizes para o tratamento cirúrgico das doenças da aorta da Sociedade Brasileira de Cirurgia Cardiovascular

Diretrizes para a cirurgia das doenças da aorta

The Evolution of Chemokine Release Supports a Bimodal Mechanism of Spinal Cord Ischemia and Reperfusion Injury

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