Motor evoked potentials in thoracoabdominal aortic surgery: PRO.

Area of Science:

• Vascular Surgery
• Neurology
• Cardiovascular Surgery

Background:

• Paraplegia is a severe complication following open repair of descending thoracic and thoracoabdominal aortic aneurysms.
• Effective spinal cord protection strategies are essential to minimize neurological deficits during these complex procedures.

Purpose of the Study:

• To outline the critical importance of spinal cord protection during thoracic and thoracoabdominal aortic aneurysm repair.
• To detail the key neuroprotective measures and monitoring techniques employed to reduce paraplegia risk.

Main Methods:

• Monitoring of motor evoked potentials to assess spinal cord function intraoperatively.
• Implementation of neuroprotective strategies including extracorporeal circulation, cerebrospinal fluid drainage, hypothermia, and selective segmental artery revascularization.

Main Results:

• Motor evoked potentials provide vital, real-time information on spinal cord integrity during aortic aneurysm repair.
• The combined application of various neuroprotective measures can significantly reduce the incidence of postoperative paraplegia.

Conclusions:

• A comprehensive spinal cord protection strategy is mandatory for patients undergoing repair of thoracic and thoracoabdominal aortic aneurysms.
• Intraoperative monitoring and targeted neuroprotective interventions are key to improving outcomes and preventing paraplegia.