[Prevention of Spinal Cord Ischemia During Thoracic Endovascular Aortic Repair]

Spinal cord ischemia(SCI) has been devastating complication of endovascular thoracic and thoracoabdominal aortic repair. Spinal cord blood supply arises from not only segmental artery, subclavian artery, hypogastric artery and these branches, but also perivertebral vasculature and paravertebral muscle and small arterial network, and risk factors of SCI were multifactorial. There are several adjuncts/strategies which are utilized to minimize the incidence of SCI: cerebrospinal fluid drainage, perioperative management of high mean arterial pressure, intraoperative evoked potential monitoring, and staged thoracoabdominal aortic repair. Recent developments including near-infrared spectroscopy, minimally invasive segmental artery coil embolization, and temporary aneurysm sac perfusion should be evaluated to prevent SCI.