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Spinal cord ischaemia

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https://www.readbyqxmd.com/read/29917121/new-insights-into-spinal-cord-ischaemia-after-thoracic-aortic-procedures-the-importance-of-the-number-of-anterior-radiculomedullary-arteries-for-surgical-outcome
#1
Fabian A Kari, Babak Saravi, Sonja Krause, Luisa Puttfarcken, Johannes Scheumann, Katharina Förster, Bartosz Rylski, Sven Maier, Ulrich Göbel, Matthias Siepe, Martin Czerny, Friedhelm Beyersdorf
OBJECTIVES: Anterior radiculomedullary arteries (ARMAs) link dorsal segmental arteries and the intraspinal compartment of the spinal collateral network. The number of thoracic ARMA is highly variable from one person to another. The impact of the number of ARMAs on spinal cord perfusion during thoracic aortic procedures is unknown. We investigated the influence of the number of thoracic ARMAs on spinal cord perfusion in an aortic surgical large animal model. METHODS: Twenty-six pigs were included (20 treatment animals, 6 sham animals, weight 34 ± 3 kg)...
July 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29882580/hyperbaric-oxygen-therapy-for-spinal-cord-ischaemia-after-complex-aortic-repair-a-retrospective-review
#2
Matteo Parotto, Maral Ouzounian, Ludwik Fedorko, George Oreopoulos, Thomas Lindsay, Rita Katznelson
BACKGROUND: Complex aortic repair (CAR) carries high rates of debilitating postoperative complications, including spinal cord injury. The rate of spinal cord deficits post-CAR is approximately 10%, with permanent paraplegia in 2.9% and paraparesis in 2.4% of patients. Treatment options are limited. Rescue therapies include optimization of spinal cord perfusion and oxygen delivery by mean arterial pressure augmentation (> 90 mm Hg), cerebrospinal fluid drainage, and preservation of adequate haemoglobin concentration (> 100 g L⁻¹)...
June 8, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29858818/advanced-magnetic-resonance-imaging-mri-techniques-of-the-spine-and-spinal-cord-in-children-and-adults
#3
REVIEW
M I Vargas, B M A Delattre, J Boto, J Gariani, A Dhouib, A Fitsiori, J L Dietemann
In this article, we illustrate the main advanced magnetic resonance imaging (MRI) techniques used for imaging of the spine and spinal cord in children and adults. This work focuses on daily clinical practice and aims to address the most common questions and needs of radiologists. We will also provide tips to solve common problems with which we were confronted. The main clinical indications for each MR technique, possible pitfalls and the challenges faced in spine imaging because of anatomical and physical constraints will be discussed...
June 1, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29705559/open-thoracic-and-thoraco-abdominal-aortic-repair-after-prior-endovascular-therapy
#4
Paula R Keschenau, Shirley Ketting, Barend Mees, Mohammad E Barbati, Jochen Grommes, Alexander Gombert, Geert Willem H Schurink, Drosos Kotelis, Michael J Jacobs
OBJECTIVE: The aim was to present current results of open thoracic and thoraco-abdominal aortic repair as secondary procedure after prior endovascular therapy. METHODS: This was a retrospective cross border single centre study. From 2006 to July 2017 45 open thoracic aortic (TAA) or thoraco-abdominal aortic aneurysm (TAAA) operations were performed on 44 patients (median age 58 [15-80] years) as secondary surgery after previous endovascular therapy comprising TEVAR (n = 38; 86%), EVAR (n = 3; 7%), fenestrated EVAR (n = 1; 2%) and TEVAR plus EVAR (n = 1; 2%)...
April 25, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29658149/coagulation-parameters-following-equine-herpesvirus-type-1-infection-in-horses
#5
M E Wilson, C L Holz, A K Kopec, J J Dau, J P Luyendyk, G Soboll Hussey
BACKGROUND: Equine herpesvirus type 1 (EHV-1) is the cause of respiratory disease, abortion storms, and outbreaks of herpesvirus myeloencephalopathy (EHM). Infection of the spinal cord is characterised by multifocal regions of virally infected vascular endothelium, associated with vasculitis, thrombosis and haemorrhage that result in ischaemia and organ dysfunction. However, the mechanism of thrombosis in affected horses is unknown. OBJECTIVES: To evaluate tissue factor (TF) procoagulant activity and thrombin-antithrombin complex (TAT) levels in horses following infection with EHV-1...
April 15, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29651329/ischaemia-of-the-medullary-cone-after-stent-graft-implantation-in-a-patient-with-abdominal-aortic-aneurysm-a-case-study
#6
Mariusz Wachowski, Michał Polguj, Janusz Ścibór, Agata Majos
Preoperative visualization of the Adamkiewicz artery - the vessel which is to a great extent responsible for supplying blood to the medullary cone - is an important step which must be taken before initiating restorative procedures in the aorta. We present a case of a 67-year-old patient who underwent an intravascular stent-graft implantation procedure, due to clinical signs of abdominal aortic aneurysm. Routine pre-operative computed tomography examination failed to demonstrate the Adamkiewicz artery. On the second day after the surgery, as a result of unexpected clinical deterioration, an magnetic resonance imaging examination of the lumbar spine was carried out...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29617826/long-term-outcomes-of-total-arch-replacement-with-the-non-frozen-elephant-trunk-technique-for-stanford-type-a-acute-aortic-dissection
#7
Yosuke Inoue, Hitoshi Matsuda, Atsushi Omura, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi
OBJECTIVES: Arch repair using the frozen elephant trunk (FET) technique has been utilized to treat Type A acute aortic dissection. In contrast, the long-term outcomes of the non-FET technique focus on the thrombosed false lumen (FL), and distal aortic reoperation rates remain unclear. The goal of our study was to investigate the efficacy and long-term outcomes of the non-FET technique as the benchmark. METHODS: We reviewed 518 patients with Type A acute aortic dissection in the last 20 years...
March 29, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29525741/spinal-cord-ischaemia-in-endovascular-thoracic-and-thoraco-abdominal-aortic-repair-review-of-preventive-strategies
#8
REVIEW
Martijn L Dijkstra, Tryfon Vainas, Clark J Zeebregts, Lotty Hooft, Maarten J van der Laan
INTRODUCTION: The incidence of spinal cord ischaemia (SCI) and subsequent paraplegia after thoracic endovascular aneurysm repair (TEVAR) and thoraco-abdominal endovascular aneurysm repair is estimated to be between 2.5% and 8%. The aim of this review is to provide an overview of SCI preventive strategies in TEVAR and thoraco-abdominal repair and recommend an optimal strategy. METHODS: Medline, Embase, and the Cochrane Library were searched for studies on TEVAR, thoraco-abdominal endovascular repair, and the use of SCI preventive measures...
March 7, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29506038/surgical-left-subclavian-artery-revascularization-for-thoracic-aortic-stent-grafting-a-single-centre-experience-in-101-patients
#9
Emma van der Weijde, Nabil Saouti, Jan Albert Vos, Selma C Tromp, Robin H Heijmen
OBJECTIVES: To evaluate the indications, perioperative strategy and postoperative outcome of surgical left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) covering the LSA. METHODS: Between 2000 and 2017, a total of 101 consecutive patients underwent surgical revascularization of the LSA prior to, concomitant or following TEVAR. Revascularization was performed through a small supraclavicular incision and consisted of a transposition or bypass graft, using intraoperative transcranial Doppler monitoring...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29497851/resolution-of-traumatic-bilateral-vertebral-artery-injury
#10
REVIEW
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29471439/robot-assisted-ligation-of-bronchial-artery-could-be-an-alternative-to-embolization
#11
Bruno Pochulu, Omar Sarsam, Christophe Peillon, Jean-Marc Baste
A 37-year-old patient presented with a self-limiting episode of moderate haemoptysis. Contrast-enhanced chest computed tomography showed a tortuous and dilated right bronchial artery arising from the descending aorta at the level of T6. Therapeutic angiography was attempted, but in the presence of spinal artery arising from the bronchial artery in question, selective embolization was contraindicated due to risk of spinal cord ischaemia. After a multidisciplinary meeting, it was decided to attempt surgery to ligate this pathological artery...
March 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29462327/risk-factors-for-spinal-cord-ischaemia-after-thoracic-endovascular-aortic-repair
#12
Toshifumi Hiraoka, Tatsuhiko Komiya, Hiroshi Tsuneyoshi, Takeshi Shimamoto
OBJECTIVES: Spinal cord ischaemia (SCI) is a serious complication of thoracic endovascular aortic repair (TEVAR). The purpose of this study was to assess the incidence, risk factors, clinical manifestations of SCI after TEVAR and which type of patients could benefit from cerebrospinal fluid drainage. METHODS: A retrospective review was conducted for 175 patients who underwent TEVAR from January 2008 to July 2014. All patients were divided into groups with and without SCI, and they were compared to identify significant risk factors for SCI...
February 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29415193/ten-year-experience-of-the-thoraco-abdominal-aortic-aneurysm-treatment-using-a-hybrid-thoracic-endovascular-aortic-repair
#13
Takashi Shuto, Tomoyuki Wada, Shinji Miyamoto, Noritaka Kamei, Norio Hongo, Hiromu Mori
OBJECTIVES: The treatment of thoraco-abdominal aortic aneurysm continues to have a high mortality and paraplegia rate. In superaging societies, the methods of performing less invasive operations remain a major issue. We reviewed our 10-year experience in the treatment of thoraco-abdominal aortic aneurysm using a hybrid procedure of combined visceral reconstruction and thoracic endovascular aortic repair. METHODS: Sixty patients underwent a hybrid repair for the treatment of the thoraco-abdominal aortic aneurysm between 2007 and 2016...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29315369/patency-of-branch-vessels-reimplanted-during-thoraco-abdominal-aortic-replacement-implications-for-the-surgical-technique
#14
Sang Yoon Kim, Suryeun Chung, Dong Jung Kim, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
OBJECTIVES: Reimplantation of branch vessels is an important component of thoraco-abdominal aortic aneurysm repair. The goal of this study was to assess the anatomical results of branch vessel reimplantation, which have rarely been investigated. METHODS: Among 168 patients who underwent computed tomography after thoraco-abdominal aortic aneurysm repair, the technique of branch vessel reimplantation and determination of their patency were investigated. Late computed tomographic images were available for 81 patients (mean interval 55...
May 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29313911/spinal-cord-injury-arising-in-anaesthesia-practice
#15
REVIEW
D W Hewson, N M Bedforth, J G Hardman
Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. The most serious causes of spinal cord injury - vertebral canal haematoma, spinal epidural abscess, meningitis and adhesive arachnoiditis - will be discussed in turn. For each condition, we draw attention to practical, evidence-based measures clinicians can undertake to reduce their incidence, or mitigate their severity...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29246434/endovascular-repair-of-acute-thoraco-abdominal-aortic-aneurysms
#16
Chiara Mascoli, Massimo Vezzosi, Andreas Koutsoumpelis, Mauro Iafrancesco, Aaron Ranasinghe, Paul Clift, Jorge Mascaro, Martin Claridge, Donald J Adam
OBJECTIVES: The outcome of endovascular repair (EVAR) for acute thoraco-abdominal aortic aneurysm (TAAA) is reported and the applicability of the t-Branch off the shelf (OTS) device is determined. METHODS: Interrogation of a prospectively maintained database identified all patients who underwent EVAR for acute TAAA between September 2012 (when the first non-elective t-Branch case was performed) and November 2015. Early and medium-term outcomes were analysed. Survival and re-intervention-free survival were calculated by Kaplan-Meier analysis...
January 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29102345/a-case-report-paediatric-surfer-s-myelopathy
#17
Rebecca Scatchard, Joao Alves Rosa, Philippa Bowen, Alex Mortimer, Peta M Sharples, Andrew L Lux
Surfer's myelopathy was first described by Thompson et al., in 2004.1 It is a rare cause of sudden spinal cord injury that occurs in the absence of direct trauma to the spinal area in novice healthy surfers. We present the case of the youngest patient we are aware of to be diagnosed with surfer's myelopathy following actual surfing. A clear aetiology for surfer's myelopathy has not previous been described. However, the hypothesis that there is ischaemia to the lower spinal cord is supported by our case, where we present the first clear angiographic evidence of the occlusion of the great anterior radicular artery of Adamkiewicz in a patient diagnosed with surfer's myelopathy...
January 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29089284/morphology-and-outcomes-of-total-endovascular-treatment-of-type-b-aortic-dissection-with-aberrant-right-subclavian-artery
#18
Min Zhou, Xueqin Bai, Yong Ding, Yonggang Wang, Changpo Lin, Dong Yan, Zhenyu Shi, Weiguo Fu
OBJECTIVES: To characterize the morphology of type B aortic dissection with aberrant right subclavian artery (ARSA) and present early and midterm outcomes of total endovascular treatment for affected patients. METHODS: From January 2010 to December 2015, patients with ARSA and type B aortic dissection treated with total endovascular techniques were enrolled. The angle of the aortic arch was measured on pre-operative CTA. Sixty age and gender matched normal aortic arch patients with type B aortic dissection served as controls...
December 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29063730/fibroblast-growth-factors-in-the-management-of-spinal-cord-injury
#19
REVIEW
Yulong Zhou, Zhouguang Wang, Jiawei Li, Xiaokun Li, Jian Xiao
Spinal cord injury (SCI) possesses a significant health and economic burden worldwide. Traumatic SCI is a devastating condition that evolves through two successive stages. Throughout each of these stages, disturbances in ionic homeostasis, local oedema, ischaemia, focal haemorrhage, free radicals stress and inflammatory response were observed. Although there are no fully restorative cures available for SCI patients, various molecular, cellular and rehabilitative therapies, such as limiting local inflammation, preventing secondary cell death and enhancing the plasticity of local circuits in the spinal cord, were described...
January 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29049608/acute-administration-of-oestradiol-or-progesterone-in-a-spinal-cord-ischaemia-reperfusion-model-in-rats
#20
Leonardo Pessoa Cavalcante, Sueli Gomes Ferreira, Daniel Romano Pereira, Sergio Rodrigues de Moraes, Rafael Simas, Paulina Sannomiya, Ana Cristina Breithaupt-Faloppa, Luiz Felipe Pinho Moreira
OBJECTIVES: Despite research into protective pharmacological adjuncts, paraplegia persists as a dreaded complication after thoracic and thoracoabdominal aortic interventions. Reports on gender-related neurological outcomes after ischaemic and traumatic brain injuries have led to increased interest in hormonal neuroprotective effects and have generated other studies seeking to prove the neuroprotective effects of the therapeutic administration of 17β-oestradiol and of progesterone. We hypothesised that acute administration of oestradiol or progesterone would prevent or attenuate spinal cord ischaemic injury induced by occlusion of the descending thoracic aorta...
February 1, 2018: Interactive Cardiovascular and Thoracic Surgery
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