Strategies to prevent TEVAR-related spinal cord ischemia

• Type: Another Publication in an International Scientific Journal
• Date: 2017

Authors

Dias-Neto M (Author) FMUP; Reis, PV (Author) Other; Rolim, D (Author) Other; Ramos, JF (Author) Other; Teixeira, JF (Author) Other; Sampaio S. (Author) FMUP

Journal

Title: Vascular

Vol. 25

Pages: 307-315

ISSN: 1708-5381

Publisher: SAGE

Indexing

ISI Web of Knowledge - 15 Citations

Scopus - 19 Citations

Other information

Authenticus ID: P-00M-8D8

DOI: 10.1177/1708538116671235

Abstract (EN): Spinal cord ischemia remains the Achilles' heel of thoracic and thoracoabdominal diseases management. Great improvements in morbidity and mortality have been obtained with the endovascular approach TEVAR (Thoracic Endovascular Aortic Repair) but this devastating complication continues to severely affect the quality of life, even if the primary success of the procedure - dissection/aneurysm exclusion - has been achieved. Several strategies to deal with this complication have been published in the literature over the time. Knowledge and technology have been evolving from identification of the risk factors associated with spinal cord ischemia, including lessons learned from open surgery, and from developments in the collateral network concept for spinal cord perfusion. In this comprehensive review, the authors cover several topics from the traditional measures comprising haemodynamic control, cerebrospinal drainage and neuroprotective drugs, to the staged-procedures approach, the emerging MISACE (minimally invasive selective segmental artery coil-embolization) and innovative neurologic monitoring such as NIRS (near-infrared spectroscopy) of the collateral network.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9