Spinal cord protection with distal perfusion for thoracic and thoracoabdominal aortic surgery

Spinal cord protection is of extreme importance to avoid the catastrophic complication of paraplegia related to surgery for thoracic and thoracoabdominal aortic disease.P-' Spinal cord injury from surgi- cally induced ischemia for aortic surgery has a variable risk of paraplegia. The incidence of spinal cord injury varies extensively-aneurysms of the proximal descending thoracic aorta and thoracoabdominal aorta 3% to 35%;to repair of traumatic rupture of the thoracic aorta performed with simple cross-clamping with- out distal perfusion, 25%;to repair of acute type B dissections of the thoracoabdominal aorta, as high as 35%.