Svensson L G, Patel V, Coselli J S, Crawford E S
Department of Surgery, Baylor College of Medicine, Houston, Texas 77030.
Ann Thorac Surg. 1990 Apr;49(4):528-35; discussion 535-6. doi: 10.1016/0003-4975(90)90297-j.
One source of paraplegia after aortic operations is the failure to reattach the spinal cord blood supply, the origins of which are not evident at operation. This report is concerned with a rapid new method of identifying these vessels intraoperatively. In 9 pigs, a specially designed catheter with platinum and stainless steel electrodes was inserted intrathecally. Saline solution saturated with hydrogen was injected sequentially into arterial ostia at T-15 to L-4 inclusive, and the generated current impulses from the conditioned platinum electrode were recorded. Of 90 potential segmental arteries supplying the spinal cord, 28 gave rise to spinal radicular arteries. Hydrogen-induced current impulses correctly located 25 of the radicular arteries and all those larger than 180 microns in diameter. When injected with indigo carmine, the vessels localized by the hydrogen-induced current impulses filled the entire anterior spinal artery from the low thoracic to the sacral region, whereas injection of the other vessels did not show filling. After refinement and testing for safety, this method has been employed clinically to rapidly localize and reattach routes of critical cord circulation.
主动脉手术后截瘫的一个原因是未能重新连接脊髓血液供应，而其血管起源在手术中并不明显。本报告关注一种在术中识别这些血管的快速新方法。在9头猪中，将带有铂和不锈钢电极的特制导管插入鞘内。将饱和氢气的盐溶液依次注入T - 15至L - 4（包括T - 15和L - 4）的动脉开口处，并记录来自经调节的铂电极产生的电流脉冲。在90条供应脊髓的潜在节段动脉中，有28条产生脊髓神经根动脉。氢气诱导的电流脉冲正确定位了25条神经根动脉以及所有直径大于180微米的神经根动脉。当注入靛胭脂时，由氢气诱导的电流脉冲定位的血管从胸下部到骶部区域充满了整个脊髓前动脉，而注入其他血管则未显示充盈。经过改进和安全性测试后，该方法已在临床上用于快速定位和重新连接关键脊髓循环路径。
