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critical limb ischemia, paraplegia

Hyangkyoung Kim, Si Hyun Kang, Don-Kyu Kim, Kyung Mook Seo, Tha Joo Kim, Joonhwa Hong
Spinal cord ischemia is rare but causes significant morbidity and mortality. Spinal cord ischemia has been reported after open and endovascular interventions of the thoracic and abdominal aorta, and, rarely, acute occlusion of aorta from in situ thrombosis or acute embolic occlusion. Acute interruption of the critical blood supply to the spinal cord or root contributes to this devastating neurologic deficit. However, gradually worsening lumbosacral plexopathy and consequent paraplegia related to chronic aortic occlusion is extremely rare...
January 2014: Journal of Vascular Surgery
Bo Fang, He Wang, Xue-Jun Sun, Xiao-Qian Li, Chun-Yu Ai, Wen-Fei Tan, Paul F White, Hong Ma
OBJECTIVE: Intrathecal administration of bone marrow stromal cells has been found to produce beneficial effects on ischemia-reperfusion injury to the spinal cord. The blood-spinal cord barrier is critical to maintain spinal cord homeostasis and neurologic function. However, the effects of bone marrow stromal cells on the blood-spinal cord barrier after spinal cord ischemia-reperfusion injury are not well understood. This study investigated the effects and possible mechanisms of bone marrow stromal cells on blood-spinal cord barrier disruption induced by spinal cord ischemia-reperfusion injury...
October 2013: Journal of Vascular Surgery
George C Chang Chien, Kenneth D Candido, Nebojsa Nick Knezevic
Digital subtraction angiography (DSA) has been touted as a radiologic adjunct to interventional neuraxial procedures where it is imperative to identify vascular compromise during the injection. Transforaminal epidural steroid injections (TFESI) are commonly performed interventions for treating acute and chronic radicular spine pain. We present a case of instantaneous and irreversible paraplegia following lumbar TFESI wherein a local anesthetic test dose, as well as DSA, were used as adjuncts to fluoroscopy...
November 2012: Pain Physician
Mohamed G Bani-Hani, Victoria Friere, Ben E Byrne, Graham R Plant, Magdy R Moawad
Spinal cord ischemia (SCI) is a rare disease that leads to variable degrees of neurological deficit including permanent paraplegia. It has been reported after open and endovascular interventions of the thoracic and abdominal aorta, but it is extremely rare after interventions involving peripheral vessels. We present a case of permanent paraplegia after iliac angioplasty and stenting for critical limb ischemia and a related review of the literature.
July 2011: Vascular and Endovascular Surgery
R Kickuth, K C Ludwig, D-D Do, M Husmann, I Baumgartner, J Triller
PURPOSE: To evaluate the feasibility and effectiveness of IVUS-guided puncture for gaining controlled target lumen reentry in subintimal recanalization of chronic iliac/femoral artery occlusions and in fenestration of aortic dissections. MATERIALS AND METHODS: Between 5/2004 and 12/2005 12 consecutive patients (7 male, 5 female; mean age 64.6 +/- 12.0 years) with chronic critical limb ischemia and ischemic complications of aortic dissection were treated using the Pioneer catheter...
September 2006: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Mitsuhiro Isaka, Hajime Kumagai, Yuji Sugawara, Kenji Okada, Kazumasa Orihashi, Megu Ohtaki, Taijiro Sueda
OBJECTIVE: We examined the protective effects of the new selective spinal cord cooling by using cold saline infusion into the cross-clamped aorta and a transvertebral cooling pad placed over the lumbar vertebral column from paraplegia caused by ischemic spinal cord injury on thoracoabdominal aortic surgery. METHODS: Eighteen rabbits were divided into three groups: groups I, II, and III (n = 6 for each group). In group I (37 degrees C; 5 mL) and group II (3 degrees C; 5 mL), saline was infused into the isolated aortic segment twice, at 0 and 5 minutes after aortic cross clamping...
June 2006: Journal of Vascular Surgery
Noud Peppelenbosch, Philippe W M Cuypers, Anco C Vahl, Frank Vermassen, Jacob Buth
BACKGROUND: Spinal cord ischemia is a rare complication after open surgical repair for ruptured abdominal aortic aneurysms (rAAA). The use of emergency endovascular aortic aneurysm repair (eEVAR) is increasing, and paraplegia has been observed in a few patients. The objective of this study was to assess the incidence and pathogenesis of spinal cord ischemia after eEVAR in greater detail. METHODS: This was a retrospective analysis of patients who had eEVAR for rAAA in three hospitals in The Netherlands and Belgium during a 3-year study period that ended in February 2004...
October 2005: Journal of Vascular Surgery
Thomas J K Toung, Yi Chang, Mel Williams, Barbara J Crain, Richard J Traystman, Anish Bhardwaj
OBJECTIVE: Paraplegia from spinal cord ischemia is a devastating complication of thoracoabdominal aortic aneurysm repair. Perioperative hypoperfusion of the spinal cord is a critical determinant of residual neurologic deficits. We determined if functional and histologic outcome is dependent on systemic blood pressure in a rat model of spinal cord ischemia. DESIGN: Randomized, controlled, prospective study. SETTING: Research laboratory at a university teaching hospital...
June 2004: Critical Care Medicine
S A Meylaerts, P De Haan, C J Kalkman, J Jaspers, I Vanicky, M J Jacobs
PURPOSE: During thoracoabdominal aortic aneurysm repair, a prolonged interruption of the spinal cord blood supply can result in irreversible spinal cord damage. The aim of this study was to investigate whether selective segmental artery perfusion during aortic clamping could prevent paraplegia in pigs. METHODS: Specially designed segmental artery perfusion catheters, which could be attached to an extracorporeal bypass graft system, were used. In experiment I (n = 10), it was assessed whether selective segmental artery perfusion could reverse electrophysiologic evidence of spinal cord ischemia and maintain transcranial motor evoked potentials (tc-MEPs) during 60 minutes of aortic cross-clamping...
July 2000: Journal of Vascular Surgery
H Hamaya
In an attempt to trace the motor neurons in the descending tract of the motor system of the spinal cord and anterior horn, we have succeeded in inducing a potential in the peripheral motor nerve (evoked motor nerve action potential: EMNAP) by stimulating the motor area of the cerebral cortex in dogs, we have examined the characteristics of this potential. Besides the EMNAP, we have induced the conventional somatosensory evoked potential (SSEP) and evoked spinal cord potential (ESCP) during spinal ischemia. These are compared with each other, with theoretical predictions and with pathological findings...
August 1993: [Zasshi] [Journal]
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