Neuromonitoring during descending aorta procedures

Mirela V Simon*, Charles C Dong, Michael J Jacobs, Werner H Mess

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterAcademic


Thoraco-abdominal aneurysm (TAA) repair carries a significant risk of spinal cord infarction. The latter results from irreversible changes in the spinal cord arterial network, e.g., sacrifice of the segmental arteries. Intra-operative neurophysiology with somatosensory and especially motor evoked potential (SEP and MEP respectively) monitoring, has emerged as an effective tool to assess the efficiency of the collateral blood flow, detect reversible spinal cord ischemia and guide the peri-operative multidisciplinary management to prevent postoperative paraplegia. The main roles of such monitoring include diagnosis of spinal cord vs peripheral limb ischemia, titration of mean arterial pressure during aortic clamping, the guidance of selective re-implantation of critical segmental arteries, and management of hemodynamics in the immediate postoperative period. In addition, manipulation of the aortic arch and proximal descending aorta, adds the risk of cerebral infarction from both low flow state and/or thromboembolic events. As such, EEG monitoring may be a useful add-on for either assessment of the efficiency of cerebral cooling as a neuroprotective method and/or for detection and treatment of reversible cerebral ischemia. This chapter presents the multimodality approach to open TAA monitoring as a versatile tool for the prevention of devastating postoperative neurologic deficits.

Original languageEnglish
Title of host publicationIntraoperative Neuromonitoring
EditorsMarc R. Nuwer, David B. MacDonald
Number of pages25
ISBN (Print)978-0-12-819826-1
Publication statusPublished - 2022

Publication series

SeriesHandbook of Clinical Neurology


  • Aortic Aneurysm, Abdominal/surgery
  • Aortic Aneurysm, Thoracic/diagnosis
  • Evoked Potentials, Motor/physiology
  • Humans
  • Ischemia
  • Monitoring, Intraoperative/methods
  • Spinal Cord/blood supply
  • Spinal Cord Ischemia/prevention & control


Dive into the research topics of 'Neuromonitoring during descending aorta procedures'. Together they form a unique fingerprint.

Cite this