SEP Monitoring During Aortic Surgery

Abstract

Surgical procedures requiring temporary occlusion of the descending aorta expose patients to the risk of ischemic injury to the spinal cord. The incidence of complete neurologic lesions complicating the resection of thoracic aortic aneurysms is reported as high as 24% of operated cases, with the greatest risk following operations for acute traumatic aortic rupture and elective resection of extensive thoraco-abdominal aortic lesions². Neurological complications are less frequent following abdominal aortic aneurysm surgery; Szilagyi et al. ⁵ reported that the incidence of spinal cord damage was 0.25% in a series of more than three thousand operations. The necessity for ligation and exclusion of multiple intercostal and lumbar vessels during the course of operative repair of lesions, mainly in the thoracic and thoraco-abdominal aorta, may result in the permanent, though inadvertent, interruption of vessels critical for blood supply to the spinal cord. Paraplegia may result. Such catastrophic neurological complications have been, up to now, undetectable during the surgical procedure.