中国神经再生研究(英文版) ›› 2021, Vol. 16 ›› Issue (4): 678-679.doi: 10.4103/1673-5374.295328

• 观点:脑损伤修复保护与再生 • 上一篇    下一篇

预防和检测复杂主动脉手术期间术中脊髓缺血的策略:引流物和生物标志物

  

  • 出版日期:2021-04-15 发布日期:2020-12-21

Strategies to prevent and detect intraoperative spinal cord ischemia during complex aortic surgery: from drainages and biomarkers

Alexander Gombert*, Florian Simon   

  1. Department of Vascular Surgery University Hospital RWTH Aachen, Aachen, Germany (Gombert A)
    Department of Vascular and Endovascular Surgery, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany (Simon F)
  • Online:2021-04-15 Published:2020-12-21
  • Contact: Alexander Gombert, MD, agombert@ukaachen.de.

摘要: https://orcid.org/0000-0001-5743-8554 (Florian Simon)

Abstract: Spinal cord ischemia (SCI), a frequent complication following open and endovascular thoracoabdominal aortic aneurysm (TAAA) repair, is a feared complication with relevant impact on a patient’s quality of life. In the early days of open TAAA repair, more than one third of the patients suffered from SCI. Nowadays, due to improved preventive measures and the option of staged  endovascular TAAA repair, 10 % of all patients are affected by spinal cord problems after TAAA repair (Rocha et al., 2020). A recently published meta-analysis could not confirm a significant lower rate of SCI after endovascular TAAA repair if compared with open repair. The particular risk factors such as an extended length of covered aortic segments above 20 cm, the placement of endografts between T9–12, the occlusion of the left subclavian or hypogastric arteries, perioperative hypotension and anemia as well as a long total procedure time remain as relevant factors affecting the risk of post-procedural SCI (Tenorio et al., 2019). Recently, preemptive interventional occlusion of intercostal arteries in the area of stent deployment has been described as a possibility to amplify the collateral network of the spinal cord before the covering of relevant arteries (Simon et al., 2020).