Shibata K, Takamoto S
Department of Cardiothoracic Surgery, University of Tokyo, Faculty of Medicine, Tokyo, Japan.
Kyobu Geka. 2004 Apr;57(4):276-9.
Paraplegia remains one of the most serious complications after thoracoabdominal aortic aneurysm surgery. Spinal cord ischemia during the operation is thought to be the most important contributor to the development of this neurological deficit. So, it is important to preserve or reconstruct the critical segmental arteries for spinal cord protection. In order to identify the critical segmental arteries, we evaluate the segmental arteries by measuring the flow velocities using Doppler ultrasonography. The flow velocities are different among segmental arteries and some segmental arteries have no flow even though they are patent. Because we think that the segmental arteries with high flow velocities have much contribution to the spinal cord perfusion, we reconstruct or preserve such segmental arteries during the operation. We hope that this method would be clinically useful for spinal cord protection during thoracoabdominal aortic aneurysm surgery.
截瘫仍然是胸腹主动脉瘤手术后最严重的并发症之一。手术期间脊髓缺血被认为是这种神经功能缺损发生的最重要因素。因此,保留或重建关键节段动脉对于保护脊髓很重要。为了确定关键节段动脉,我们使用多普勒超声通过测量流速来评估节段动脉。各节段动脉的流速不同,有些节段动脉尽管通畅但却没有血流。因为我们认为流速高的节段动脉对脊髓灌注有很大贡献,所以在手术期间我们重建或保留这些节段动脉。我们希望这种方法在胸腹主动脉瘤手术中对脊髓保护具有临床实用性。