Spinal cord preservation in thoracoabdominal aneurysm repair

Spinal cord injury (SCI) stands as one of the most dreadful complications of thoracoabdominal aneurysm repair. Despite the less invasive nature and recent technical advancements of endovascular aortic repair, SCI still remains a significant danger in endovascular approaches. However, as our understanding of the collateral network of spinal cord vasculature has grown, it has become evident that the incidence of paraplegia and paraparesis in conjunction with endovascular procedures can be minimized through the use of many of the same strategies that have proven successful in reducing SCI associated with open surgical repair. This article highlights important aspects of spinal cord protection, which have been derived from the authors' clinical and experimental experience.