Recovery of lost motor evoked potentials in open thoracoabdominal aortic aneurysm repair using intercostal artery bypass

Alexander Gombert; Jochen Grommes; Danny Hilkman; Drosos Kotelis; Werner H. Mess; Michael J. Jacobs

doi:10.1016/j.jvscit.2017.12.004

Recovery of lost motor evoked potentials in open thoracoabdominal aortic aneurysm repair using intercostal artery bypass

Alexander Gombert^*, Jochen Grommes, Danny Hilkman, Drosos Kotelis, Werner H. Mess, Michael J. Jacobs

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases.

Original language	English
Pages (from-to)	54-57
Number of pages	4
Journal	Journal of Vascular Surgery Cases and Innovative Techniques
Volume	4
Issue number	1
DOIs	https://doi.org/10.1016/j.jvscit.2017.12.004
Publication status	Published - 1 Mar 2018

Keywords

COLLATERAL NETWORK CONCEPT
SURGERY
REPLACEMENT
PARAPLEGIA
PROTECTION

Access to Document

10.1016/j.jvscit.2017.12.004Licence: CC BY-NC-ND

Cite this

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title = "Recovery of lost motor evoked potentials in open thoracoabdominal aortic aneurysm repair using intercostal artery bypass",

abstract = "Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases.",

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AU - Gombert, Alexander

AU - Grommes, Jochen

AU - Hilkman, Danny

AU - Kotelis, Drosos

AU - Mess, Werner H.

AU - Jacobs, Michael J.

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases.

AB - Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases.

KW - COLLATERAL NETWORK CONCEPT

KW - SURGERY

KW - REPLACEMENT

KW - PARAPLEGIA

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DO - 10.1016/j.jvscit.2017.12.004

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